Synergistic effect of simvastatin and ezetimibe on lipid and pro-inflammatory profiles in pre-diabetic subjects
<p>Abstract</p> <p>Background</p> <p>Ezetimibe specifically blocks the absorption of dietary and biliary cholesterol and plant sterols. Synergism of ezetimibe-statin therapy on LDL-cholesterol has been demonstrated, but data concerning the pleiotropic effects of this co...
| Main Authors: | , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2010-06-01
|
| Series: | Diabetology & Metabolic Syndrome |
| Online Access: | http://www.dmsjournal.com/content/2/1/34 |
| _version_ | 1818351532300566528 |
|---|---|
| author | Kater Ana-Lucia A Batista Marcelo C Ferreira Sandra RG |
| author_facet | Kater Ana-Lucia A Batista Marcelo C Ferreira Sandra RG |
| author_sort | Kater Ana-Lucia A |
| collection | DOAJ |
| description | <p>Abstract</p> <p>Background</p> <p>Ezetimibe specifically blocks the absorption of dietary and biliary cholesterol and plant sterols. Synergism of ezetimibe-statin therapy on LDL-cholesterol has been demonstrated, but data concerning the pleiotropic effects of this combination are controversial.</p> <p>Objective</p> <p>This open-label trial evaluated whether the combination of simvastatin and ezetimibe also results in a synergistic effect that reduces the pro-inflammatory status of pre-diabetic subjects.</p> <p>Methods</p> <p>Fifty pre-diabetic subjects were randomly assigned to one of 2 groups, one receiving ezetimibe (10 mg/day), the other, simvastatin (20 mg/d) for 12 weeks, followed by an additional 12-week period of combined therapy. Blood samples were collected at baseline, 12 and 24 weeks. RESULTS: Total cholesterol, LDL-cholesterol and apolipoprotein B levels decreased in all the periods analyzed (p < 0.01), but triglycerides declined significantly only after combined therapy. Both drugs induced reductions in C-reactive protein, reaching statistical significance after combining ezetimibe with the simvastatin therapy (baseline 0.59 ± 0.14, simvastatin monotherapy 0.48 ± 0.12 mg/dL and 0.35 ± 0.12 mg/dL, p < 0.023). Such a reduction was independent of LDL-cholesterol change. However, mean levels of TNF-α and interleukin-6 and leukocyte count did not vary during the whole study.</p> <p>Conclusion</p> <p>Expected synergistic lowering effects of a simvastatin and ezetimibe combination on LDL-cholesterol, apolipoprotein B and triglycerides levels were confirmed in subjects with early disturbances of glucose metabolism. We suggest an additive effect of this combination also on inflammatory status based on the reduction of C-reactive protein. Attenuation of pro-inflammatory conditions may be relevant in reducing cardiometabolic risk.</p> <p>Title/ID of trial registration</p> <p>Effect of simvastatin and ezetimibe on lipid and inflammation/NCT01103648.</p> |
| first_indexed | 2024-12-13T18:39:14Z |
| format | Article |
| id | doaj.art-2ed9c991895e4575bbe80cd017462037 |
| institution | Directory Open Access Journal |
| issn | 1758-5996 |
| language | English |
| last_indexed | 2024-12-13T18:39:14Z |
| publishDate | 2010-06-01 |
| publisher | BMC |
| record_format | Article |
| series | Diabetology & Metabolic Syndrome |
| spelling | doaj.art-2ed9c991895e4575bbe80cd0174620372022-12-21T23:35:16ZengBMCDiabetology & Metabolic Syndrome1758-59962010-06-01213410.1186/1758-5996-2-34Synergistic effect of simvastatin and ezetimibe on lipid and pro-inflammatory profiles in pre-diabetic subjectsKater Ana-Lucia ABatista Marcelo CFerreira Sandra RG<p>Abstract</p> <p>Background</p> <p>Ezetimibe specifically blocks the absorption of dietary and biliary cholesterol and plant sterols. Synergism of ezetimibe-statin therapy on LDL-cholesterol has been demonstrated, but data concerning the pleiotropic effects of this combination are controversial.</p> <p>Objective</p> <p>This open-label trial evaluated whether the combination of simvastatin and ezetimibe also results in a synergistic effect that reduces the pro-inflammatory status of pre-diabetic subjects.</p> <p>Methods</p> <p>Fifty pre-diabetic subjects were randomly assigned to one of 2 groups, one receiving ezetimibe (10 mg/day), the other, simvastatin (20 mg/d) for 12 weeks, followed by an additional 12-week period of combined therapy. Blood samples were collected at baseline, 12 and 24 weeks. RESULTS: Total cholesterol, LDL-cholesterol and apolipoprotein B levels decreased in all the periods analyzed (p < 0.01), but triglycerides declined significantly only after combined therapy. Both drugs induced reductions in C-reactive protein, reaching statistical significance after combining ezetimibe with the simvastatin therapy (baseline 0.59 ± 0.14, simvastatin monotherapy 0.48 ± 0.12 mg/dL and 0.35 ± 0.12 mg/dL, p < 0.023). Such a reduction was independent of LDL-cholesterol change. However, mean levels of TNF-α and interleukin-6 and leukocyte count did not vary during the whole study.</p> <p>Conclusion</p> <p>Expected synergistic lowering effects of a simvastatin and ezetimibe combination on LDL-cholesterol, apolipoprotein B and triglycerides levels were confirmed in subjects with early disturbances of glucose metabolism. We suggest an additive effect of this combination also on inflammatory status based on the reduction of C-reactive protein. Attenuation of pro-inflammatory conditions may be relevant in reducing cardiometabolic risk.</p> <p>Title/ID of trial registration</p> <p>Effect of simvastatin and ezetimibe on lipid and inflammation/NCT01103648.</p>http://www.dmsjournal.com/content/2/1/34 |
| spellingShingle | Kater Ana-Lucia A Batista Marcelo C Ferreira Sandra RG Synergistic effect of simvastatin and ezetimibe on lipid and pro-inflammatory profiles in pre-diabetic subjects Diabetology & Metabolic Syndrome |
| title | Synergistic effect of simvastatin and ezetimibe on lipid and pro-inflammatory profiles in pre-diabetic subjects |
| title_full | Synergistic effect of simvastatin and ezetimibe on lipid and pro-inflammatory profiles in pre-diabetic subjects |
| title_fullStr | Synergistic effect of simvastatin and ezetimibe on lipid and pro-inflammatory profiles in pre-diabetic subjects |
| title_full_unstemmed | Synergistic effect of simvastatin and ezetimibe on lipid and pro-inflammatory profiles in pre-diabetic subjects |
| title_short | Synergistic effect of simvastatin and ezetimibe on lipid and pro-inflammatory profiles in pre-diabetic subjects |
| title_sort | synergistic effect of simvastatin and ezetimibe on lipid and pro inflammatory profiles in pre diabetic subjects |
| url | http://www.dmsjournal.com/content/2/1/34 |
| work_keys_str_mv | AT kateranaluciaa synergisticeffectofsimvastatinandezetimibeonlipidandproinflammatoryprofilesinprediabeticsubjects AT batistamarceloc synergisticeffectofsimvastatinandezetimibeonlipidandproinflammatoryprofilesinprediabeticsubjects AT ferreirasandrarg synergisticeffectofsimvastatinandezetimibeonlipidandproinflammatoryprofilesinprediabeticsubjects |