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.
Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Anticholesteremic Agents/administration & dosage , Azetidines/administration & dosage , Cholesterol, LDL/drug effects , Fluorobenzenes/administration & dosage , Hydroxymethylglutaryl-CoA Reductase Inhibitors/administration & dosage , Hypercholesterolemia/drug therapy , Pyrimidines/administration & dosage , Simvastatin/administration & dosage , Sulfonamides/administration & dosage , Biomarkers/blood , Cholesterol, LDL/blood , Drug Therapy, Combination , Prospective StudiesABSTRACT
A phenomenological description is given of the mesophases which may arise below a liquid formed from achiral molecules possessing a transverse dipole, as the result of a coupling between their tilt and polar orders. Six stable mesophases are found. Two of them have a cholesteric biaxial structure. The others display antiferroelectric or ferrielectric, incommensurately modulated, structures with in-plane or out-of-plane spontaneous polarization. The in-plane polarized structures become unstable under application of a longitudinal electric field. Other field-induced effects are discussed.
ABSTRACT
Wetting a glass surface with a sponge phase is shown to induce an anisotropic, presumably lamellar, interface structure. This static effect, and the corresponding induced birefringence measurements, are described in the framework of a theoretical phase diagram involving the sponge and lamellar phases, and taking into account a surface field and the existence of a transition between two, direct and inverted, sponge regions.
ABSTRACT
Experimental investigations of lyotropic cholesterics fluids are presented which show that changes in the shape anisotropy and chirality of the micellar population determine the topology of the temperature-concentration phase diagrams. For given amounts of the substances which induce the chirality and modify the shape anisotropy of the micelles, two distinct biaxial cholesteric phases are disclosed in the phase diagrams. This is interpreted in the framework of the catastrophe theory of phase transitions.
ABSTRACT
An analogy is stressed between the order-parameter symmetries of the two-dimensional d-pairing wave superconductors and of liquid-crystal mesophases formed from achiral bent-shaped molecules. It leads to a definition of a class of liquid-crystal states which are the analogs of the unconventional superconducting states, and are characterized by a loss of discrete symmetry operations of the parent state.
