The effect of micronized fenofibrate (Lipanthyl 200 M, Laboratoire Fournier, France, in dose 200 mg per day) on the serum level of 7 alpha-hydroxycholesterol (7 alpha-(OH)C) was studied in 10 men (aged 31-60 years) with hyperlipidemia (total C > 6.5 mmol/l). The levels of 7 alpha-(OH)C as well as that of total C, LDL C, VLDL C and HDL C and triglycerides (Tg) were measured before Lipanthyl 200 M treatment (point 0) and after 1, 2 and 3 months of the drug administration. The content of 7 alpha-(OH)C was determined by the reversed phase HPLC after the enzymatic conversion of serum 7 alpha-(OH)C to 7 alpha-(OH)-4-cholesten-3-one in cholesterol oxidase reaction. 7 beta-(OH)C was used as the internal recovery standard. Lipanthyl treatment resulted in considerable reduction of total C, VLDL C and LDL C levels and 7 alpha-(OH)C content. After the second and third months of therapy serum levels of 7 alpha-(OH)C were significantly reduced from 1.3 +/- 0.1 to 0.8 +/- 0.2 and 0.7 +/- 0.1 mumol/l; (P < 0.02). The decrease of 7 alpha-(OH)C content was associated with the decrease in Tg and VLDL C levels. Thus, our data suggest that the level of 7 alpha-(OH)C of in human serum may be used as an indicator of intensity of cholesterol oxidation into bile acids.