Takahashi Sadao, Zenimaru Yasuo, Suzuki Jinya, Miyamori Isamu
Department of Endocrinology and Metabolism, Faculty of Medical Science, University of Fukui.
Nihon Ronen Igakkai Zasshi. 2009;46(6):545-50. doi: 10.3143/geriatrics.46.545.
A 65-year-old woman had been treated for type 2 diabetes mellitus, familial hypercholesterolemia and old myocardial infarction. Combination therapy of atorvastatin (40 mg/day), ethyl icosapentate (1,200 mg/day), probucol (500 mg/day) and colestimide (1 g/day) had never reached an ideal low-density lipoprotein cholesterol (LDL-C) level. However the conversion to high dose of colestimide (4 g/day) with the same dose of atorvastatin, ethyl icosapentate, and probucol obviously decreased her LDL-C level from 181.2 mg/dl to 148 mg/dl. Reduction of LDL-C level was also associated with the lowering of glycohemoglobin A1c from 10.7% to 8.7% simultaneously. Challenge tests by the cessation and resumption of only colestimide treatment clearly indicated that colestimide has both cholesterol and blood glucose lowering effect. Her body weight and appetite did not change by colestimide treatment. We think that colestimide therapy might provide a beneficial effect on atherosclerotic disease in diabetes mellitus with dyslipidemia through reduction of cholesterol and blood glucose.
一名65岁女性曾接受2型糖尿病、家族性高胆固醇血症和陈旧性心肌梗死的治疗。阿托伐他汀(40毫克/天)、二十碳五烯酸乙酯(1200毫克/天)、普罗布考(500毫克/天)和考来替米(1克/天)的联合治疗从未达到理想的低密度脂蛋白胆固醇(LDL-C)水平。然而,将考来替米剂量增至高剂量(4克/天),同时阿托伐他汀、二十碳五烯酸乙酯和普罗布考剂量不变,明显使她的LDL-C水平从181.2毫克/分升降至148毫克/分升。LDL-C水平的降低还与糖化血红蛋白A1c同时从10.7%降至8.7%有关。仅通过停止和恢复考来替米治疗进行的激发试验清楚地表明,考来替米具有降低胆固醇和血糖的作用。考来替米治疗未改变她的体重和食欲。我们认为,考来替米治疗可能通过降低胆固醇和血糖,对伴有血脂异常的糖尿病患者的动脉粥样硬化疾病产生有益影响。