Differences in synthesis and absorption of cholesterol of two effective lipid-lowering therapies
Braz. j. med. biol. res
;
45(11): 1095-1101, Nov. 2012. ilus, tab
Article
in English
| LILACS
| ID: lil-650576
ABSTRACT
Effective statin therapy is associated with a marked reduction of cardiovascular events. However, the explanation for full benefits obtained for LDL cholesterol targets by combined lipid-lowering therapy is controversial. Our study compared the effects of two equally effective lipid-lowering strategies on markers of cholesterol synthesis and absorption. A prospective, open label, randomized, parallel design study, with blinded endpoints, included 116 subjects. We compared the effects of a 12-week treatment with 40 mg rosuvastatin or the combination of 40 mg simvastatin/10 mg ezetimibe on markers of cholesterol absorption (campesterol and β-sitosterol), synthesis (desmosterol), and their ratios to cholesterol. Both therapies similarly decreased total and LDL cholesterol, triglycerides and apolipoprotein B, and increased apolipoprotein A1 (P < 0.05 vs baseline for all). Simvastatin/ezetimibe increased plasma desmosterol (P = 0.012 vs baseline), and decreased campesterol and β-sitosterol (P < 0.0001 vs baseline for both), with higher desmosterol (P = 0.007) and lower campesterol and β-sitosterol compared to rosuvastatin, (P < 0.0001, for both). In addition, rosuvastatin increased the ratios of these markers to cholesterol (P < 0.002 vs baseline for all), whereas simvastatin/ezetimibe significantly decreased the campesterol/cholesterol ratio (P = 0.008 vs baseline) and tripled the desmosterol/cholesterol ratio (P < 0.0001 vs baseline). The campesterol/cholesterol and β-sitosterol/cholesterol ratios were lower, whereas the desmosterol/cholesterol ratio was higher in patients receiving simvastatin/ezetimibe (P < 0.0001 vs rosuvastatin, for all). Pronounced differences in markers of cholesterol absorption and synthesis were observed between two equally effective lipid-lowering strategies.
Full text:
Available
Index:
LILACS (Americas)
Main subject:
Pyrimidines
/
Sulfonamides
/
Azetidines
/
Hydroxymethylglutaryl-CoA Reductase Inhibitors
/
Simvastatin
/
Fluorobenzenes
/
Hypercholesterolemia
/
Cholesterol, LDL
/
Anticholesteremic Agents
Type of study:
Controlled clinical trial
/
Observational study
/
Risk factors
Limits:
Adult
/
Aged
/
Female
/
Humans
/
Male
Language:
English
Journal:
Braz. j. med. biol. res
Journal subject:
Biology
/
Medicine
Year:
2012
Type:
Article
Affiliation country:
Brazil
Institution/Affiliation country:
Instituto Nacional de Ciência e Tecnologia de Fluidos Complexos/BR
/
Synchrophar/BR
/
Universidade Federal de São Paulo/BR
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