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Yanai H, Adachi H, Hakoshima M, Katsuyama H. Atherogenic Lipoproteins for the Statin Residual Cardiovascular Disease Risk. Int J Mol Sci 2022; 23:ijms232113499. [PMID: 36362288 PMCID: PMC9657259 DOI: 10.3390/ijms232113499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Revised: 11/01/2022] [Accepted: 11/02/2022] [Indexed: 11/06/2022] Open
Abstract
Randomized controlled trials (RCTs) show that decreases in low-density lipoprotein cholesterol (LDL-C) by the use of statins cause a significant reduction in the development of cardiovascular disease (CVD). However, one of our previous studies showed that, among eight RCTs that investigated the effect of statins vs. a placebo on CVD development, 56–79% of patients had residual CVD risk after the trials. In three RCTs that investigated the effect of a high dose vs. a usual dose of statins on CVD development, 78–87% of patients in the high-dose statin arms still had residual CVD risk. The risk of CVD development remains even when statins are used to strongly reduce LDL-C, and this type of risk is now regarded as statin residual CVD risk. Our study shows that elevated triglyceride (TG) levels, reduced high-density lipoprotein cholesterol (HDL-C), and the existence of obesity/insulin resistance and diabetes may be important metabolic factors that determine statin residual CVD risk. Here, we discuss atherogenic lipoproteins that were not investigated in such RCTs, such as lipoprotein (a) (Lp(a)), remnant lipoproteins, malondialdehyde-modified LDL (MDA-LDL), and small-dense LDL (Sd-LDL). Lp(a) is under strong genetic control by apolipoprotein (a), which is an LPA gene locus. Variations in the LPA gene account for 91% of the variability in the plasma concentration of Lp(a). A meta-analysis showed that genetic variations at the LPA locus are associated with CVD events during statin therapy, independent of the extent of LDL lowering, providing support for exploring strategies targeting circulating concentrations of Lp(a) to reduce CVD events in patients receiving statins. Remnant lipoproteins and small-dense LDL are highly associated with high TG levels, low HDL-C, and obesity/insulin resistance. MDA-LDL is a representative form of oxidized LDL and plays important roles in the formation and development of the primary lesions of atherosclerosis. MDA-LDL levels were higher in CVD patients and diabetic patients than in the control subjects. Furthermore, we demonstrated the atherogenic properties of such lipoproteins and their association with CVD as well as therapeutic approaches.
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Affiliation(s)
- Hidekatsu Yanai
- Correspondence: ; Tel.: +81-473-72-3501; Fax: +81-473-72-1858
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2
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Serum Malondialdehyde-Modified Low-Density Lipoprotein Is a Risk Factor for Central Arterial Stiffness in Maintenance Hemodialysis Patients. Nutrients 2020; 12:nu12072160. [PMID: 32708072 PMCID: PMC7401258 DOI: 10.3390/nu12072160] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2020] [Revised: 07/12/2020] [Accepted: 07/18/2020] [Indexed: 12/15/2022] Open
Abstract
Circulating malondialdehyde-modified low-density lipoprotein (MDA-LDL) acts as a marker of oxidative stress and is associated with atherosclerotic cardiovascular disease. The relationship between serum MDA-LDL levels and aortic stiffness (AS) in patients with hemodialysis (HD) was evaluated. There were 155 HD patients enrolled in this study. Carotid-femoral pulse wave velocity (cfPWV) was measured by a validated tonometry system. Patients with cfPWV >10 m/s were used to define the AS group, while those with values of ≤10 m/s were regarded as the control group. Serum MDA-LDL levels were measured using a commercial enzyme-linked immunosorbent assay. Sixty-eight patients (43.9%) who were defined as AS sufferers, and were older, had a higher percentage of diabetes and hypertension and higher systolic blood pressure and serum MDA-LDL level compared to subjects in the control group. After adjusting for factors significantly associated with AS by multivariable logistic regression analysis, it was revealed that serum MDA-LDL levels, diabetes, and hypertension were independent predictors of AS in HD patients. Multivariable forward stepwise linear regression analysis also showed that a logarithmically transformed MDA-LDL level was significantly correlated with cfPWV values in HD patients. In HD patients, a high serum MDA-LDL level was positively associated with cfPWV values and was a significant predictor of the development of high AS.
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Strilchuk L, Tocci G, Fogacci F, Cicero AFG. An overview of rosuvastatin/ezetimibe association for the treatment of hypercholesterolemia and mixed dyslipidemia. Expert Opin Pharmacother 2020; 21:531-539. [DOI: 10.1080/14656566.2020.1714028] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Affiliation(s)
- Larysa Strilchuk
- Department of Therapy and Medical Diagnostics, Lviv National Medical University, Lviv, Ukraine
| | - Giuliano Tocci
- Department of Clinical and Molecular Medicine, Faculty of Medicine and Psychology, University of Rome Sapienza, Sant’Andrea Hospital, Rome, Italy
- Cardiology Unit, IRCCS Neuromed, Pozzilli, Italy
| | - Federica Fogacci
- Medical and Surgical Sciences Department, Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Arrigo F. G. Cicero
- Medical and Surgical Sciences Department, Alma Mater Studiorum University of Bologna, Bologna, Italy
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Reklou A, Katsiki N, Karagiannis A, Athyros V. Effects of Lipid Lowering Drugs on Arterial Stiffness: One More Way to Reduce Cardiovascular Risk? Curr Vasc Pharmacol 2019; 18:38-42. [DOI: 10.2174/1570161117666190121102323] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2018] [Revised: 01/10/2019] [Accepted: 01/10/2019] [Indexed: 01/12/2023]
Abstract
Arterial stiffness (AS) is considered an independent predictor of cardiovascular disease
(CVD) events. Among lipid lowering drugs, statins have a beneficial effect on AS, independent of their
hypolipidaemic effect. Based on 3 meta-analyses and other studies, this effect is compound- and doserelated.
Potent statins at high doses are more effective than less powerful statins. Ezetimibe (± statin)
also seems to decrease AS in patients with dyslipidaemia. Fibrates have no effect on AS. Proprotein
convertase subtilisin/kexin type 9 (PCSK9) inhibitors have data that beneficially affect all AS risk factors,
suggesting a beneficial effect on artery compliance. However, there is no direct measurement of
their effect on AS indices. In patients with dyslipidaemia, prescribing high dose statins (± ezetimibe)
will not only decrease low-density lipoprotein cholesterol levels but also improve AS (in addition to
other effects). This effect on AS may contribute to the observed reduction in vascular events.
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Affiliation(s)
- Andromachi Reklou
- Second Propedeutic Department of Internal Medicine, Hippocration Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Niki Katsiki
- Second Propedeutic Department of Internal Medicine, Hippocration Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Asterios Karagiannis
- Second Propedeutic Department of Internal Medicine, Hippocration Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Vasilios Athyros
- Second Propedeutic Department of Internal Medicine, Hippocration Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
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5
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Shaposhnik II, Genkel VV. [Pleiotropic effects of ezetimibe]. KARDIOLOGIIA 2019; 59:12-17. [PMID: 31995721 DOI: 10.18087/cardio.n875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/04/2019] [Revised: 11/13/2019] [Accepted: 12/10/2019] [Indexed: 06/10/2023]
Abstract
The article discusses in detail the question of the additional positive effects of ezetimibe in addition to direct hypolipidemic action. The data of experimental and clinical studies in which the effect of ezetimibe on carbohydrate metabolism, inflammation, endothelial dysfunction, and liver is studied. The article also discusses the results of clinical studies that examined the effect of ezetimibe on atherosclerotic plaque.
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Affiliation(s)
- I I Shaposhnik
- Federal State Budgetary Educational Institution of Higher Education "South-Ural State Medical University" of the Ministry of Healthcare of the Russian Federation
| | - V V Genkel
- Federal State Budgetary Educational Institution of Higher Education "South-Ural State Medical University" of the Ministry of Healthcare of the Russian Federation
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Jones PJH, Shamloo M, MacKay DS, Rideout TC, Myrie SB, Plat J, Roullet JB, Baer DJ, Calkins KL, Davis HR, Barton Duell P, Ginsberg H, Gylling H, Jenkins D, Lütjohann D, Moghadasian M, Moreau RA, Mymin D, Ostlund RE, Ras RT, Ochoa Reparaz J, Trautwein EA, Turley S, Vanmierlo T, Weingärtner O. Progress and perspectives in plant sterol and plant stanol research. Nutr Rev 2019; 76:725-746. [PMID: 30101294 DOI: 10.1093/nutrit/nuy032] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Current evidence indicates that foods with added plant sterols or stanols can lower serum levels of low-density lipoprotein cholesterol. This review summarizes the recent findings and deliberations of 31 experts in the field who participated in a scientific meeting in Winnipeg, Canada, on the health effects of plant sterols and stanols. Participants discussed issues including, but not limited to, the health benefits of plant sterols and stanols beyond cholesterol lowering, the role of plant sterols and stanols as adjuncts to diet and drugs, and the challenges involved in measuring plant sterols and stanols in biological samples. Variations in interindividual responses to plant sterols and stanols, as well as the personalization of lipid-lowering therapies, were addressed. Finally, the clinical aspects and treatment of sitosterolemia were reviewed. Although plant sterols and stanols continue to offer an efficacious and convenient dietary approach to cholesterol management, long-term clinical trials investigating the endpoints of cardiovascular disease are still lacking.
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Affiliation(s)
- Peter J H Jones
- Richardson Centre for Functional Foods and Nutraceuticals, University of Manitoba, Winnipeg, Manitoba, Canada.,Department of Food and Human Nutritional Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Maryam Shamloo
- Department of Food and Human Nutritional Sciences, University of Manitoba, Winnipeg, Manitoba, Canada.,George and Fay Yee Centre for Healthcare Innovation, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Dylan S MacKay
- George and Fay Yee Centre for Healthcare Innovation, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Todd C Rideout
- Department of Exercise and Nutrition Sciences, University of Buffalo, Buffalo, New York, USA
| | - Semone B Myrie
- Richardson Centre for Functional Foods and Nutraceuticals, University of Manitoba, Winnipeg, Manitoba, Canada.,Department of Food and Human Nutritional Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Jogchum Plat
- Department of Human Biology, Maastricht University, Maastricht, the Netherlands
| | - Jean-Baptiste Roullet
- Division of Metabolism, Child Development and Rehabilitation Center-Portland, Department of Pediatrics, Oregon Health & Science University, Portland, Oregon, USA
| | - David J Baer
- US Department of Agriculture, Agricultural Research Service, Beltsville Human Nutrition Research Center, Beltsville, Maryland, USA
| | - Kara L Calkins
- Department of Pediatrics, Division of Neonatology, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California, USA; and the UCLA Mattel's Children's Hospital, Los Angeles, California, USA
| | | | - P Barton Duell
- Knight Cardiovascular Institute, Oregon Health & Science University, Portland, Oregon, USA
| | - Henry Ginsberg
- Institute of Human Nutrition, Columbia University Irving Medical Center, New York, New York, USA
| | - Helena Gylling
- University of Helsinki and the Helsinki University Central Hospital, Helsinki, Finland
| | - David Jenkins
- Department of Nutritional Sciences, University of Toronto, Toronto, Ontario, Canada; and the Clinical Nutrition and Risk Factor Modification Centre, St. Michael's Hospital, Toronto, Ontario, Canada
| | - Dieter Lütjohann
- Institute for Clinical Chemistry and Clinical Pharmacology, University of Bonn, Bonn, Germany
| | - Mohammad Moghadasian
- Department of Food and Human Nutritional Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Robert A Moreau
- Eastern Regional Research Center, US Department of Agriculture, Agricultural Research Service, Wyndmoor, Pennsylvania, USA
| | - David Mymin
- Department of Internal Medicine, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Richard E Ostlund
- Division of Endocrinology, Metabolism and Lipid Research, Washington University, St Louis, USA
| | - Rouyanne T Ras
- Unilever Research & Development Vlaardingen, Vlaardingen, the Netherlands
| | | | - Elke A Trautwein
- Unilever Research & Development Vlaardingen, Vlaardingen, the Netherlands
| | | | - Tim Vanmierlo
- Department of Immunology and Biochemistry, Biomedical Research Institute, Hasselt University, Hasselt, Belgium
| | - Oliver Weingärtner
- Klinik für Innere Medizin I, Universitätsklinikum Jena, Friedrich-Schiller-Universität Jena, Jena, Germany; Abteilung für Kardiologie, Klinikum Oldenburg, European Medical School Oldenburg-Groningen, Oldenburg, Germany
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7
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Sakuma M, Toyoda S, Hashimoto R, Yazawa H, Masuyama T, Hirose S, Waku R, Hasumi H, Numao T, Abe S, Inoue T. Add-on ezetimibe treatment to low-dose statins vs medium-intensity statin monotherapy in coronary artery disease patients with poorly controlled dyslipidemia. Hypertens Res 2019; 42:1923-1931. [DOI: 10.1038/s41440-019-0308-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2019] [Revised: 06/17/2019] [Accepted: 06/26/2019] [Indexed: 12/31/2022]
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8
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Katsiki N, Mikhailidis DP, Banach M. Lipid-lowering agents for concurrent cardiovascular and chronic kidney disease. Expert Opin Pharmacother 2019; 20:2007-2017. [DOI: 10.1080/14656566.2019.1649394] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Affiliation(s)
- Niki Katsiki
- Diabetes Center, Division of Endocrinology and Metabolism, First Department of Internal Medicine, AHEPA University Hospital, Medical School Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Dimitri P Mikhailidis
- Department of Clinical Biochemistry, Royal Free Hospital Campus, University College London Medical School, University College London (UCL), London, UK
| | - Maciej Banach
- Department of Hypertension, WAM University Hospital in Lodz, Medical University of Lodz, Lodz, Poland
- Polish Mother’s Memorial Hospital Research Institute (PMMHRI), Lodz, Poland
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9
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Dolezelova E, Stein E, Derosa G, Maffioli P, Nachtigal P, Sahebkar A. Effect of ezetimibe on plasma adipokines: a systematic review and meta-analysis. Br J Clin Pharmacol 2017; 83:1380-1396. [PMID: 28166606 DOI: 10.1111/bcp.13250] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2016] [Revised: 01/22/2017] [Accepted: 01/27/2017] [Indexed: 12/11/2022] Open
Abstract
AIMS Statins are known to influence the status of adipokines, which play a key role in the pathophysiology of cardiometabolic diseases. As the effect of ezetimibe as an add-on to statin therapy on the impact of statins on plasma adipokines levels is currently unclear, the aim of the present study was to investigate this through a meta-analysis of controlled trials. METHODS A systematic review was performed, followed by a bibliographic search in PubMed, Medline, SCOPUS, Web of Science and Google Scholar databases. Quantitative data synthesis was performed using a fixed- or random-effects model (based on the level of interstudy heterogeneity) and the generic inverse variance weighting method. Effect sizes were expressed as standardized mean difference (SMD) and 95% confidence interval (CI). RESULTS Meta-analysis of 23 controlled trials did not suggest any significant effect of adding ezetimibe on top of statin therapy on plasma concentrations of adiponectin (SMD 0.34, 95% CI -0.28, 0.96; P = 0.288), leptin (SMD -0.75, 95% CI: -2.35, 0.85; P = 0.360), plasminogen activator inhibitor 1 (SMD -1.06, 95% CI: -2.81, 0.69; P = 0.236) and interleukin 6 (SMD 0.30, 95% CI: -0.08, 0.67; P = 0.124). However, significantly greater reductions in plasma concentrations of tumour necrosis factor α (TNF-α) (SMD -0.48, 95% CI -0.87, -0.08; P = 0.018) were achieved with ezetimibe/statin combination therapy. CONCLUSIONS The results suggested that ezetimibe add-on to statin therapy is associated with an enhanced TNF-α-lowering effect compared with statin monotherapy. Owing to the emerging role of TNF-α in the pathogenesis of metabolic disorders, further investigations are required to unveil the translational relevance of this TNF-α-lowering effect.
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Affiliation(s)
- Eva Dolezelova
- Faculty of Pharmacy in Hradec Kralove, Department of Biological and Medical Sciences, Charles University, Hradec Kralove, Czech Republic
| | - Evan Stein
- Metabolic and Atherosclerosis Research Center, Cincinnati, OH, USA
| | - Giuseppe Derosa
- Centre of Diabetes and Metabolic Diseases, Department of Internal Medicine and Therapeutics, University of Pavia and Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.,Center for the Study of Endocrine-Metabolic Pathophysiology and Clinical Research, University of Pavia, Pavia, Italy.,Molecular Medicine Laboratory, University of Pavia, Pavia, Italy
| | - Pamela Maffioli
- Centre of Diabetes and Metabolic Diseases, Department of Internal Medicine and Therapeutics, University of Pavia and Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.,PhD School in Experimental Medicine, University of Pavia, Pavia, Italy
| | - Petr Nachtigal
- Faculty of Pharmacy in Hradec Kralove, Department of Biological and Medical Sciences, Charles University, Hradec Kralove, Czech Republic
| | - Amirhossein Sahebkar
- Biotechnology Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.,School of Medicine, University of Western Australia, Perth, WA, Australia
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Shimabukuro M, Okawa C, Yamada H, Yanagi S, Uematsu E, Sugasawa N, Kurobe H, Hirata Y, Kim-Kaneyama JR, Lei XF, Takao S, Tanaka Y, Fukuda D, Yagi S, Soeki T, Kitagawa T, Masuzaki H, Sato M, Sata M. The pathophysiological role of oxidized cholesterols in epicardial fat accumulation and cardiac dysfunction: a study in swine fed a high caloric diet with an inhibitor of intestinal cholesterol absorption, ezetimibe. J Nutr Biochem 2016; 35:66-73. [DOI: 10.1016/j.jnutbio.2016.05.010] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2016] [Revised: 04/29/2016] [Accepted: 05/19/2016] [Indexed: 12/25/2022]
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Coadministration of ezetimibe with pegylated interferon plus ribavirin could improve early virological response in chronic hepatitis C obese Egyptian patients. Eur J Gastroenterol Hepatol 2016; 28:553-7. [PMID: 26872109 DOI: 10.1097/meg.0000000000000587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Abstract
BACKGROUND Ezetimibe has been reported to inhibit viral entry and to reduce BMI and has been proposed as a novel therapeutic agent for chronic hepatitis C (CHC), potentiating the effects of pegylated interferon and ribavirin (peg-IFN/RBV). OBJECTIVE The aim of the study was to assess the effects of ezetimibe coadministration with peg-IFN/RBV combination on the early virological response (EVR) rates in nonobese and obese patients with CHC genotype 4 (CHC-4). PATIENTS AND METHODS A total of 144 CHC-4 patients were divided into two groups; group 1 included nonobese patients (n=76) and group 2 included obese patients (n=68). Each group was further subclassified into equal control and treated groups. The control groups received peg-IFN/RBV combination for 24 weeks, and the treated groups received peg-IFN/RBV plus ezetimibe for 12 weeks and then only peg-IFN/RBV for the remaining 12 weeks. RESULTS The study revealed that EVR significantly improved in the obese patients (85.3 vs. 64.7% in the treated and control groups, respectively, at P<0.05) without any significant improvement in the nonobese patients. Biochemical responses (defined as normalization of alanine aminotransferase at week 12) were markedly improved in the treated groups in both the nonobese and obese groups compared with their respective controls. CONCLUSION The addition of ezetimibe to peg-IFN/RBV combination significantly improves EVR rates in obese patients compared with nonobese patients, and remarkably improves the biochemical responses in both obese and nonobese patients with CHC-4. This may shed light on a new strategy for the treatment of CHC, particularly in obese Egyptian patients.
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Kato R, Nishioka S, Nomura A, Ijiri Y, Miyamura M, Ukimura A, Okada Y, Kitaura Y, Hayashi T. Cardiovascular protection by ezetimibe and influence on oxidative stress in mice exposed to intermittent hypoxia. Eur J Pharmacol 2015; 765:7-14. [PMID: 26276396 DOI: 10.1016/j.ejphar.2015.08.013] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2015] [Revised: 07/03/2015] [Accepted: 08/10/2015] [Indexed: 01/03/2023]
Abstract
Ezetimibe is as an inhibitor of NPC1L1 protein, which has a key role in cholesterol absorption. The aim of this study was to evaluate the influence of ezetimibe on the plasma lipid profile, atherosclerotic lesions, and cardiomyocyte ultrastructure in an animal model of atherosclerosis with intermittent hypoxia. Apolipoprotein E-knockout mice received a high-fat diet for 30 days. Then animals were exposed to intermittent hypoxia for 10 days or were maintained under normoxic conditions. In the ezetimibe group, ezetimibe (5 mg/kg/day) was added to the diet. Under normoxic conditions, the total cholesterol level was significantly lower in the ezetimibe group (63.6±6.6 mg/dl) than in the control group (116.3±16.9 mg/dl, P<0.001). Intermittent hypoxia accelerated atherosclerosis associated with increased superoxide production, which also caused degeneration of cardiomyocytes, mitochondrial abnormalities, and interstitial fibrosis. Compared with the control group, the ezetimibe group showed significantly less advanced atherosclerotic lesions and lower superoxide production in the thoracic aorta, as well as reduced oxidative stress, preservation of cardiomyocyte ultrastructure, and reduced interstitial fibrosis in the left ventricular myocardium. In conclusion, ezetimibe not only reduces total cholesterol, but also prevents the development of atherosclerosis and cardiovascular events due to intermittent hypoxia at least partly through suppression of oxidative stress.
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Affiliation(s)
- Ryuji Kato
- Laboratory of Cardiovascular Pharmacotherapy and Toxicology, Osaka University of Pharmaceutical Sciences, 4-20-1 Nasahara, Takatsuki, Osaka 569-1094, Japan
| | - Satoshi Nishioka
- Laboratory of Pathological and Molecular Pharmacology, Osaka University of Pharmaceutical Sciences, 4-20-1 Nasahara, Takatsuki, Osaka 569-1094, Japan
| | - Atsuo Nomura
- Laboratory of Cardiovascular Pharmacotherapy and Toxicology, Osaka University of Pharmaceutical Sciences, 4-20-1 Nasahara, Takatsuki, Osaka 569-1094, Japan
| | - Yoshio Ijiri
- Laboratory of Cardiovascular Pharmacotherapy and Toxicology, Osaka University of Pharmaceutical Sciences, 4-20-1 Nasahara, Takatsuki, Osaka 569-1094, Japan
| | - Masatoshi Miyamura
- Department of Internal Medicine III, Osaka Medical College, 2-7 Daigaku-machi, Takatsuki, Osaka 569-8686, Japan
| | - Akira Ukimura
- Department of Internal Medicine III, Osaka Medical College, 2-7 Daigaku-machi, Takatsuki, Osaka 569-8686, Japan
| | - Yoshikatsu Okada
- Department of Pathology, Osaka Medical College, 2-7 Daigaku-machi, Takatsuki, Osaka 569-8686, Japan
| | - Yasushi Kitaura
- Department of Internal Medicine III, Osaka Medical College, 2-7 Daigaku-machi, Takatsuki, Osaka 569-8686, Japan
| | - Tetsuya Hayashi
- Laboratory of Cardiovascular Pharmacotherapy and Toxicology, Osaka University of Pharmaceutical Sciences, 4-20-1 Nasahara, Takatsuki, Osaka 569-1094, Japan.
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13
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Ras RT, Fuchs D, Koppenol WP, Garczarek U, Greyling A, Keicher C, Verhoeven C, Bouzamondo H, Wagner F, Trautwein EA. The effect of a low-fat spread with added plant sterols on vascular function markers: results of the Investigating Vascular Function Effects of Plant Sterols (INVEST) study. Am J Clin Nutr 2015; 101:733-41. [PMID: 25809853 PMCID: PMC4381780 DOI: 10.3945/ajcn.114.102053] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND Plant sterols (PSs) lower LDL cholesterol, an established risk factor for coronary artery disease (CAD). No direct evidence is available supporting a reduced risk of CAD for foods with added PSs. Endothelial dysfunction is seen as an early indicator of atherosclerotic damage. OBJECTIVES This study was primarily designed to investigate the effect of a low-fat spread with added PSs on brachial artery endothelial function as measured by flow-mediated dilation (FMD). Second, effects on arterial stiffness, blood pressure, serum lipids, and plasma PS concentrations were investigated. We hypothesized that PSs would not worsen FMD but would rather modestly improve FMD. DESIGN This study had a double-blind, randomized, placebo-controlled, parallel design. After a 4-wk run-in period, 240 hypercholesterolemic but otherwise healthy men and women consumed 20 g/d of low-fat spread without (control) or with added PSs (3 g/d) during 12 wk. Pre- and postintervention, vascular function measurements and blood sampling were performed. RESULTS In total, 232 participants completed the study period. For the primary endpoint FMD, 199 participants were included in the statistical analysis. PS intake did not affect FMD (+0.01 percentage points; 95% CI: -0.73, 0.75) compared with control. Measures of arterial stiffness (pulse wave velocity and augmentation index) and blood pressure were also not significantly changed compared with control. After PS intervention, LDL cholesterol significantly decreased on average by 0.26 mmol/L (95% CI: -0.40, -0.12) or 6.7% compared with control. Plasma sitosterol and campesterol concentrations significantly increased in the PS group up to on average 11.5 μmol/L and 13.9 μmol/L (expressed as geometric means), respectively. CONCLUSIONS The intake of a low-fat spread with added PSs neither improved nor worsened FMD or other vascular function markers in hypercholesterolemic men and women. As expected, serum LDL cholesterol decreased, whereas plasma PSs increased after PS intake. This study was registered at clinicaltrials.gov as NCT01803178.
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Affiliation(s)
- Rouyanne T Ras
- From Unilever Research and Development Vlaardingen, Vlaardingen, The Netherlands (RTR, DF, WPK, UG, AG, CV, HB, and EAT), and Charité Research Organisation, Berlin, Germany (CK and FW)
| | - Dagmar Fuchs
- From Unilever Research and Development Vlaardingen, Vlaardingen, The Netherlands (RTR, DF, WPK, UG, AG, CV, HB, and EAT), and Charité Research Organisation, Berlin, Germany (CK and FW)
| | - Wieneke P Koppenol
- From Unilever Research and Development Vlaardingen, Vlaardingen, The Netherlands (RTR, DF, WPK, UG, AG, CV, HB, and EAT), and Charité Research Organisation, Berlin, Germany (CK and FW)
| | - Ursula Garczarek
- From Unilever Research and Development Vlaardingen, Vlaardingen, The Netherlands (RTR, DF, WPK, UG, AG, CV, HB, and EAT), and Charité Research Organisation, Berlin, Germany (CK and FW)
| | - Arno Greyling
- From Unilever Research and Development Vlaardingen, Vlaardingen, The Netherlands (RTR, DF, WPK, UG, AG, CV, HB, and EAT), and Charité Research Organisation, Berlin, Germany (CK and FW)
| | - Christian Keicher
- From Unilever Research and Development Vlaardingen, Vlaardingen, The Netherlands (RTR, DF, WPK, UG, AG, CV, HB, and EAT), and Charité Research Organisation, Berlin, Germany (CK and FW)
| | - Carole Verhoeven
- From Unilever Research and Development Vlaardingen, Vlaardingen, The Netherlands (RTR, DF, WPK, UG, AG, CV, HB, and EAT), and Charité Research Organisation, Berlin, Germany (CK and FW)
| | - Hakim Bouzamondo
- From Unilever Research and Development Vlaardingen, Vlaardingen, The Netherlands (RTR, DF, WPK, UG, AG, CV, HB, and EAT), and Charité Research Organisation, Berlin, Germany (CK and FW)
| | - Frank Wagner
- From Unilever Research and Development Vlaardingen, Vlaardingen, The Netherlands (RTR, DF, WPK, UG, AG, CV, HB, and EAT), and Charité Research Organisation, Berlin, Germany (CK and FW)
| | - Elke A Trautwein
- From Unilever Research and Development Vlaardingen, Vlaardingen, The Netherlands (RTR, DF, WPK, UG, AG, CV, HB, and EAT), and Charité Research Organisation, Berlin, Germany (CK and FW)
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Fujihara K, Suzuki H, Sato A, Kodama S, Heianza Y, Saito K, Iwasaki H, Kobayashi K, Yatoh S, Takahashi A, Yahagi N, Yagyu H, Sone H, Shimano H. Circulating malondialdehyde-modified LDL-related variables and coronary artery stenosis in asymptomatic patients with type 2 diabetes. J Diabetes Res 2015; 2015:507245. [PMID: 25883985 PMCID: PMC4391491 DOI: 10.1155/2015/507245] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2014] [Revised: 03/08/2015] [Accepted: 03/10/2015] [Indexed: 02/07/2023] Open
Abstract
AIMS To elucidate the levels of malondialdehyde-modified LDL (MDA-LDL)-related variables for predicting coronary artery stenosis (CAS) by coronary CT angiography (CCTA) in asymptomatic patients with type 2 diabetes (T2DM). METHODS Enrolled were 36 Japanese patients with T2DM who underwent CCTA and in whom MDA-LDL levels were measured. Definition of CAS was luminal narrowing of ≥50%. Trends through tertiles of each MDA-LDL-related variable were analyzed with a general linear model. The ability of each MDA-LDL-related variable to predict CAS was compared to areas under the curve (AUCs) in receiver operating characteristic curve (ROC) analysis. RESULTS Seventeen patients had CAS. Each MDA-LDL-related variable was an independent predictor of CAS (P = 0.039 for MDALDL, P = 0.013 for MDA-LDL/LDL-C, P = 0.047 for MDA-LDL/HDL-C, and P = 0.013 for (MDA-LDL/LDL-C)/HDL-C). AUCs of MDA-LDL, MDA-LDL/LDL-C, MDA-LDL/HDL-C, and (MDA-LDL/LDL-C)/HDL-C were 0.675 (95% CI 0.496-0.854), 0.765 (0.602-0.927), 0.752 (0.592-0.913), and 0.799 (0.643-0.955), respectively, for predicting CAS. Trends throughout the tertiles showed significant associations between MDA-LDL/LDL-C, MDA-LDL/HDL-C, or (MDALDL/LDL-C)/HDL-C and CAS (P = 0.003 for MDA-LDL/LDL-C, P = 0.042 for MDA-LDL/HDL-C, and P = 0.001 for (MDA-LDL/LDL-C)/HDL-C). CONCLUSIONS Data suggest that measurements of MDA-LDL/LDL-C, MDA-LDL/HDLC, and (MDA-LDL/LDL-C)/HDL-C are useful for predicting CAS.
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Affiliation(s)
- Kazuya Fujihara
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki 305-8575, Japan
| | - Hiroaki Suzuki
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki 305-8575, Japan
- *Hiroaki Suzuki:
| | - Akira Sato
- Division of Cardiology, Department of Internal Medicine, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki 305-8575, Japan
| | - Satoru Kodama
- Department of Hematology, Endocrinology and Metabolism, School of Medicine, Niigata University, Niigata, Niigata 951-8510, Japan
| | - Yoriko Heianza
- Department of Hematology, Endocrinology and Metabolism, School of Medicine, Niigata University, Niigata, Niigata 951-8510, Japan
| | - Kazumi Saito
- Division of Endocrinology and Metabolism, Center for Medical Sciences, Ibaraki Prefectural University of Health Sciences, Ami, Ibaraki 300-0331, Japan
| | - Hitoshi Iwasaki
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki 305-8575, Japan
| | - Kazuto Kobayashi
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki 305-8575, Japan
| | - Shigeru Yatoh
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki 305-8575, Japan
| | - Akimitsu Takahashi
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki 305-8575, Japan
| | - Naoya Yahagi
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki 305-8575, Japan
| | - Hiroaki Yagyu
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki 305-8575, Japan
| | - Hirohito Sone
- Department of Hematology, Endocrinology and Metabolism, School of Medicine, Niigata University, Niigata, Niigata 951-8510, Japan
| | - Hitoshi Shimano
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki 305-8575, Japan
- International Institute for Integrative Sleep Medicine (WPI-IIIS), University of Tsukuba, Tsukuba, Ibaraki 305-8575, Japan
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Ohbu-Murayama K, Adachi H, Hirai Y, Enomoto M, Fukami A, Obuchi A, Yoshimura A, Nakamura S, Nohara Y, Nakao E, Umeki Y, Fukumoto Y. Ezetimibe combined with standard diet and exercise therapy improves insulin resistance and atherosclerotic markers in patients with metabolic syndrome. J Diabetes Investig 2014; 6:325-33. [PMID: 25969718 PMCID: PMC4420565 DOI: 10.1111/jdi.12298] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2014] [Revised: 09/19/2014] [Accepted: 10/05/2014] [Indexed: 01/02/2023] Open
Abstract
Aims/Introduction Ezetimibe lowers serum lipid levels by inhibiting intestinal absorption of dietary and biliary cholesterol. However, the effect of ezetimibe on insulin resistance remains unclear. The aim of the present study was to examine this issue in patients with metabolic syndrome in local-dwelling Japanese, who were not being treated with lipid-lowering drugs. Materials and Methods In 2009, 1,943 participants received a health examination in the Tanushimaru Study, a Japanese cohort of the Seven Countries Study, of whom 490 participants had metabolic syndrome. Among them, 61 participants (41 men and 20 women) were examined in the present study. They were treated with 10 mg of ezetimibe once a day for 24 weeks, combined with standard diet and exercise therapy. Results Bodyweight (P < 0.001), body mass index (P < 0.001), systolic blood pressure (P = 0.003), diastolic blood pressure (P < 0.001), triglycerides (P = 0.002), non-high-density lipoprotein cholesterol (P = 0.001), low-density lipoprotein cholesterol (P < 0.001) and homeostasis model assessment of insulin resistance (P = 0.011) significantly decreased after the observational period. There were no statistically significant differences in the effects of ezetimibe between men and women. Univariate analysis showed that the reduction of homeostasis model assessment of insulin resistance was not associated with the improvement of other metabolic components. Conclusions Ezetimibe combined with standard diet and exercise therapy improves not only bodyweight and atherogenic lipid profiles, but also insulin resistance, blood pressure and anthropometric factors in metabolic syndrome in local-dwelling Japanese. Interestingly, the improvement of insulin resistance had no correlation with other metabolic components.
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Affiliation(s)
- Kyoko Ohbu-Murayama
- Department of Internal Medicine, Division of Cardio-Vascular Medicine Kurume, Japan
| | - Hisashi Adachi
- Department of Community Medicine, Kurume University School of Medicine Kurume, Japan
| | - Yuji Hirai
- Department of Internal Medicine, Division of Cardio-Vascular Medicine Kurume, Japan
| | - Mika Enomoto
- Department of Internal Medicine, Division of Cardio-Vascular Medicine Kurume, Japan
| | - Ako Fukami
- Department of Internal Medicine, Division of Cardio-Vascular Medicine Kurume, Japan
| | - Aya Obuchi
- Department of Internal Medicine, Division of Cardio-Vascular Medicine Kurume, Japan
| | - Ayako Yoshimura
- Department of Internal Medicine, Division of Cardio-Vascular Medicine Kurume, Japan
| | - Sachiko Nakamura
- Department of Internal Medicine, Division of Cardio-Vascular Medicine Kurume, Japan
| | - Yume Nohara
- Department of Internal Medicine, Division of Cardio-Vascular Medicine Kurume, Japan
| | - Erika Nakao
- Department of Internal Medicine, Division of Cardio-Vascular Medicine Kurume, Japan
| | - Yoko Umeki
- Department of Internal Medicine, Division of Cardio-Vascular Medicine Kurume, Japan
| | - Yoshihiro Fukumoto
- Department of Internal Medicine, Division of Cardio-Vascular Medicine Kurume, Japan
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Trocha M, Merwid-Ląd A, Chlebda E, Sozański T, Pieśniewska M, Gliniak H, Szeląg A. Influence of ezetimibe on selected parameters of oxidative stress in rat liver subjected to ischemia/reperfusion. Arch Med Sci 2014; 10:817-24. [PMID: 25276169 PMCID: PMC4175761 DOI: 10.5114/aoms.2013.38087] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2011] [Revised: 02/21/2012] [Accepted: 04/01/2012] [Indexed: 12/21/2022] Open
Abstract
INTRODUCTION Ischemia/reperfusion (I/R) is considered to be one of the main causes of liver damage after transplantation. The authors evaluated the effect of ezetimibe on selected oxidative stress parameters in ischemic/reperfused (I/R) rat liver. MATERIAL AND METHODS Rats were administered ezetimibe (5 mg/kg) (groups E and E-I/R) or saline solution (groups C and C-I/R) intragastrically for 21 days. Livers of animals in groups C-I/R and E-I/R were subjected to 60 min of partial ischemia (left lateral and median lobes) followed by 4 h of reperfusion. Alanine and asparagine aminotransferase (ALT, AST) activity was determined in blood before I/R and during reperfusion (at 15 and 240 min). After the reperfusion period, malondialdehyde (MDA), superoxide dismutase (SOD), glutathione (GSH) and glutathione peroxidase (GPx) were determined in liver homogenates using colorimetric methods. RESULTS Ezetimibe caused a significant increase in GSH level in groups subjected to I/R (E-I/R (99.91 ±9.01) vs. C-I/R (90.51 ±8.87), p < 0.05). Additionally, under I/R the decrease of GPx activity in the drug-treated group was lower compared to the non-treated group (E-I/R (3.88 ±1.11) vs. E (5.31 ±1.83), p = 0.076). Neither ezetimibe nor I/R affected SOD or MDA levels. I/R produced a significant increase in aminotransferase levels (ALT240-0: C-I/R (42.23 ±43.56) vs. C (9.75 ±11.09), and E-I/R (39.85 ±26.53) vs. E (4.38 ±1.36), p < 0.05 in both cases; AST 240-0: E-I/R (53.87 ±17.23) vs. E (24.10 ±9.66), p < 0.05) but no effect of ezetimibe on those enzymes was found. CONCLUSIONS Ezetimibe demonstrates antioxidant properties in rat livers subjected to I/R. However, neither a hepatoprotective nor a hepatotoxic effect of ezetimibe was demonstrated, regardless of I/R.
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Affiliation(s)
| | - Anna Merwid-Ląd
- Department of Pharmacology, Wroclaw Medical University, Poland
| | - Ewa Chlebda
- Department of Pharmacology, Wroclaw Medical University, Poland
| | - Tomasz Sozański
- Department of Pharmacology, Wroclaw Medical University, Poland
| | | | - Halina Gliniak
- Department of Pharmacology, Wroclaw Medical University, Poland
| | - Adam Szeląg
- Department of Pharmacology, Wroclaw Medical University, Poland
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Simvastatin but not ezetimibe reduces sympathetic activity despite similar reductions in cholesterol levels. ACTA ACUST UNITED AC 2014; 8:715-23. [PMID: 25418493 DOI: 10.1016/j.jash.2014.06.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2014] [Revised: 06/12/2014] [Accepted: 06/19/2014] [Indexed: 11/20/2022]
Abstract
The relationship between the sympatholytic effects of statins and their lipid-lowering activity remains unclear. Ezetimibe lowers cholesterol, but its sympatholytic activity is unknown. The purpose of study was to compare the influence of equipotent doses of simvastatin and ezetimibe on sympathetic activity. This randomized double-blinded study was performed in 22 hypertensive patients (age, 45.6 ± 2.2 years; female/male, 2/20) with untreated hypercholesterolemia. The subjects were administered 20 mg/d of simvastatin (n = 11) or 20 mg/d of ezetimibe (n = 11) for 6 weeks. Pre- and post-treatment measurements of muscle sympathetic nerve activity (MSNA), baroreceptor control of heart rate (baroreflex sensitivity), and impedance cardiography were recorded. Simvastatin and ezetimibe produced similar reductions of total (-58.0 ± 23.4 vs. -45.2 ± 17.2 mg/dL; P = .15, respectively) and low-density lipoprotein cholesterol (-52.6 ± 20.9 vs. -37.9 ± 17.6 mg/dL; P = .09, respectively). There was a significant difference in the effect of simvastatin and ezetimibe on muscle sympathetic nerve activity (-8.5 ± 5.1 vs. -0.7 ± 3.5 bursts/min; P = .0005). Simvastatin improved baroreflex sensitivity as compared with ezetimibe (10.0 ± 14.3 vs. -2.8 ± 6.1 ms/mm Hg; P = .01). There was no difference in the effect of both treatments on blood pressure, heart rate, cardiac output, stroke volume, total peripheral resistance, high-density lipoprotein, and triglycerides. Simvastatin reduced sympathetic activity via lipid-independent mechanisms, but ezetimibe exerts no sympatholytic effects.
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18
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Shen KP, Lin HL, Chang WT, Lin JC, An LM, Chen IJ, Wu BN. Eugenosedin-A ameliorates hyperlipidemia-induced vascular endothelial dysfunction via inhibition of α1-adrenoceptor/5-HT activity and NADPH oxidase expression. Kaohsiung J Med Sci 2013; 30:116-24. [PMID: 24581211 DOI: 10.1016/j.kjms.2013.10.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2013] [Accepted: 08/14/2013] [Indexed: 01/03/2023] Open
Abstract
Eugenosedin-A (Eu-A) effects on vascular endothelial dysfunction and oxidative stress in a hyperlipidemic rat model were investigated. Rats were randomly divided into four groups: two control groups and two treatment groups. The control rats received a regular diet or high fat diet (HFD); the treatment rats fed received an HFD with 5 mg/kg Eu-A or atorvastatin for 10 weeks. No changes in serotonin levels were observed in the four groups; norepinephrine levels were enhanced in the HFD group which was attenuated by Eu-A and atorvastatin. In the HFD group, the vascular reactivity was increased by vasoconstrictors (5-nonyloxytryptamine, 5-HT, and phenylephrine) and decreased by an endothelium-dependent vasorelaxant, carbachol. Protein levels of α1-adrenergic receptors (not 5-HT1B/2A), reactive oxygen species (ROS) p47(phox), p67(phox), and gp91(phox), and oxidative damage markers 3-nitrotyrosine (3-NT) and 4-hydroxy-2-nonenal (4-HNE) were increased, but endothelial nitric oxide synthase (eNOS), P-eNOS and vasodilator-stimulated phosphoprotein phosphorylation (P-VASP) were decreased. Catalase and superoxide dismutase (SOD-1 and SOD-2) proteins were increased, but glutathione peroxidase (GPx) was decreased in the aorta. Eu-A and atorvastatin reduced vasoconstrictor-induced aortic contractions that might be related to 5-HT1B/2A and α1-adrenergic receptors inhibitory activities. Eu-A and atorvastatin improved eNOS/P-eNOS, P-VASP, GPx, and malondialdehyde (MDA) levels, and decreased ROS and oxidative damage markers. Taken together, we suggest that Eu-A can ameliorate hyperlipidemia-induced vascular endothelial dysfunction and oxidative dysregulation.
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Affiliation(s)
- Kuo-Ping Shen
- Department of Nursing, Meiho University, Pingtung, Taiwan
| | - Hui-Li Lin
- Department of Food Science and Nutrition, Meiho University, Pingtung, Taiwan
| | - Wen-Tsan Chang
- Division of Hepatobiliarypancreatic Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Jou-Chun Lin
- Department of Ophthalmology, Kaohsiung Municipal United Hospital, Kaohsiung, Taiwan
| | - Li-Mei An
- Department of Pharmacology, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Ing-Jun Chen
- Department of Pharmacology, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Bin-Nan Wu
- Department of Pharmacology, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
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19
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Comparison of the effect of simvastatin versus simvastatin/ezetimibe versus rosuvastatin on markers of inflammation and oxidative stress in subjects with hypercholesterolemia. Atherosclerosis 2013; 231:8-14. [DOI: 10.1016/j.atherosclerosis.2013.08.013] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2013] [Revised: 07/27/2013] [Accepted: 08/13/2013] [Indexed: 01/08/2023]
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20
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Yamazaki D, Ishida M, Watanabe H, Nobori K, Oguma Y, Terata Y, Koyama T, Iino K, Kosaka T, Ito H. Comparison of anti-inflammatory effects and high-density lipoprotein cholesterol levels between therapy with quadruple-dose rosuvastatin and rosuvastatin combined with ezetimibe. Lipids Health Dis 2013; 12:9. [PMID: 23374898 PMCID: PMC3598241 DOI: 10.1186/1476-511x-12-9] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2012] [Accepted: 01/31/2013] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Statins are frequently administered to reduce low-density lipoprotein cholesterol (LDL-C) and vascular inflammation, because LDL-C and high sensitive C-reactive protein (hs-CRP) are associated with high risk for cardiovascular events. When statins do not reduce LDL-C to desired levels in high-risk patients with coronary artery disease (CAD), ezetimibe can be added or the statin dose can be increased. However, which strategy is more effective for treating patients with CAD has not been established. The present study compares anti-inflammatory effects and lipid profiles in patients with CAD and similar LDL-C levels who were treated by increasing the statin dose or by adding ezetimibe to the original rosuvastatin dose to determine the optimal treatment for such patients. METHODS 46 patients with high-risk CAD and LDL-C and hs-CRP levels of >70 mg/dL and >1.0 mg/L, respectively, that were not improved by 4 weeks of rosuvastatin (2.5 mg/day) were randomly assigned to receive 10 mg (R10, n = 24) of rosuvastatin or 2.5 mg/day of rosuvastatin combined with 10 mg/day of ezetimibe (R2.5/E10, n = 22) for 12 weeks. The primary endpoint was a change in hs-CRP. RESULTS Baseline characteristics did not significantly differ between the groups. At 12 weeks, LDL-C and inflammatory markers (hs-CRP, interleukin-6, tumour necrosis factor-alpha and pentraxin 3) also did not significantly differ between the two groups (LDL-C: R10 vs. R2.5/E10: -19.4 ± 14.2 vs. -22.4 ± 14.3 mg/dL). However, high-density lipoprotein cholesterol (HDL-C) was significantly improved in the R10, compared with R2.5/E10 group (4.6 ± 5.9 vs. 0.0 ± 6.7 mg/dL; p < 0.05). CONCLUSION Both enhanced therapies exerted similar anti-inflammatory effects under an equal LDL-C reduction in patients with high-risk CAD despite 2.5 mg/day of rosuvastatin. However, R10 elevated HDL-C more effectively than R2.5/E10. TRIAL REGISTRATION UMIN000003746.
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Affiliation(s)
- Daisuke Yamazaki
- Department of Cardiovascular Medicine, Akita University Graduate School of Medicine, Hondo 1-1-1, Akita, 010-8543, Japan
| | - Masaru Ishida
- Department of Cardiovascular Medicine, Akita University Graduate School of Medicine, Hondo 1-1-1, Akita, 010-8543, Japan
| | - Hiroyuki Watanabe
- Department of Cardiovascular Medicine, Akita University Graduate School of Medicine, Hondo 1-1-1, Akita, 010-8543, Japan
| | - Kiyoshi Nobori
- Department of Cardiovascular Medicine, Akita University Graduate School of Medicine, Hondo 1-1-1, Akita, 010-8543, Japan
| | - Yasunori Oguma
- Department of Cardiovascular Medicine, Akita University Graduate School of Medicine, Hondo 1-1-1, Akita, 010-8543, Japan
| | - Yutaka Terata
- Department of Cardiovascular Medicine, Akita University Graduate School of Medicine, Hondo 1-1-1, Akita, 010-8543, Japan
| | - Takashi Koyama
- Department of Cardiovascular Medicine, Akita University Graduate School of Medicine, Hondo 1-1-1, Akita, 010-8543, Japan
| | - Kenji Iino
- Department of Cardiovascular Medicine, Akita University Graduate School of Medicine, Hondo 1-1-1, Akita, 010-8543, Japan
| | - Toshimitsu Kosaka
- Department of Cardiovascular Medicine, Akita University Graduate School of Medicine, Hondo 1-1-1, Akita, 010-8543, Japan
| | - Hiroshi Ito
- Department of Cardiovascular Medicine, Akita University Graduate School of Medicine, Hondo 1-1-1, Akita, 010-8543, Japan
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Takahara M, Katakami N, Kishida K, Kaneto H, Funahashi T, Shimomura I, Matsunaga S, Kubo S, Fukamizu H, Otsuka A, Ichihara K, Nakamura T. Circulating Adiponectin Levels and their Associated Factors in Young Lean Healthy Japanese Women. J Atheroscler Thromb 2013; 20:57-64. [DOI: 10.5551/jat.14357] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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Takase H, Dohi Y, Okado T, Hashimoto T, Goto Y, Kimura G. Effects of ezetimibe on visceral fat in the metabolic syndrome: a randomised controlled study. Eur J Clin Invest 2012; 42:1287-94. [PMID: 23033884 DOI: 10.1111/eci.12000] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
BACKGROUND Although visceral obesity, a key abnormality in the metabolic syndrome, is an important risk for cardiovascular diseases, reduction in visceral fat is hard to achieve despite intensive efforts directed at lifestyle modification. The present study was designed to investigate whether ezetimibe, an inhibitor of intestinal cholesterol absorption through its binding to Niemann-Pick C1-like 1, reduces visceral fat in patients with metabolic syndrome. MATERIALS AND METHODS Seventy-eight outpatients (63·7 ± 10·4 years old) with metabolic syndrome were enroled and randomly assigned to receive either ezetimibe (10 mg/day) or nothing for 6 months. Changes in visceral fat were assessed by computed tomography. RESULTS Treatment with ezetimibe significantly improved lipid profiles. Visceral fat was decreased 7·2%, from 161·3 ± 58·6 cm(2) to 148·4 ± 52·7 cm(2) (P < 0·05), and adiponectin was increased 7·7%, from 3·61 ± 3·10 μg/mL to 3·86 ± 3·62 μg/mL (P < 0·05), after ezetimibe therapy; these beneficial effects were not observed in the control group. The increase in the adiponectin level was correlated with the reduction in visceral fat after ezetimibe treatment. Furthermore, ezetimibe reduced fasting insulin levels (P < 0·05) and improved the homoeostasis model assessment of insulin resistance (HOMA-IR) (P < 0·05). CONCLUSIONS Ezetimibe reduces visceral fat with beneficial effects on adiponectin and insulin resistance in patients with metabolic syndrome, suggesting a new therapeutic approach in such patients.
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Affiliation(s)
- Hiroyuki Takase
- Department of Internal Medicine, Enshu Hospital, Hamamatsu, Japan
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