Utsunomiya Social Insurance Hospital, Tochigi, Japan.
Endocr J. 2010;57(10):903-8. doi: 10.1507/endocrj.k10e-055. Epub 2010 Aug 20.
To date, there are very few clinical reports that have compared the effects of ezetimibe on lipid parameters between hypercholesterolemic patients with and without type 2 diabetes mellitus (T2DM). In this study, we recruited patients for hypercholesterolemic groups with T2DM (n = 42; men/women = 24/18; HbA1c = 6.7 ± 5.4%) and without T2DM (n = 21; men/women = 7/14; HbA1c = 5.3 ± 0.4%). Patients were prescribed ezetimibe at a dose of 10 mg/daily for the course of the 12-week study. At baseline and after 12 weeks of treatment, several lipid parameters, including serum low-density-lipoprotein cholesterol (LDL-C), non-high-density-lipoprotein cholesterol (non-HDL-C), high-sensitivity C-reactive protein (hs-CRP), and cholesterol synthesis/absorption-related markers, were measured. Compared with those at the baseline, the levels of LDL-C, non-HDL-C, campesterol, and sitosterol were significantly reduced after 12 weeks of ezetimibe treatment in both groups. After adjusting for confounding factors, such as age, gender, smoking, and BMI, the levels of LDL-C and non-HDL-C displayed significantly greater reductions in the patients with T2DM (-25.1 ± 13.6% in LDL-C, -20.5 ± 11.2% in non-HDL-C) than those without T2DM (-20.5 ± 7.8% in LDL-C, P < 0.05; -17.4 ± 7.6% in non-HDL-C, P < 0.05). The reduction of the level of cholestanol was significantly and positively correlated with those of LDL-C and non-HDL-C in the patients with T2DM. Taken together, these findings indicate that ezetimibe could reduce the levels of atherogenic lipoproteins to a greater extent in hypercholesterolemic patients with T2DM than in those without T2DM.
迄今为止，很少有临床报告比较了依折麦布对伴有和不伴有 2 型糖尿病（T2DM）的高胆固醇血症患者的血脂参数的影响。在这项研究中，我们招募了 T2DM 高胆固醇血症组的患者（n = 42；男/女 = 24/18；HbA1c = 6.7 ± 5.4%）和不伴有 T2DM 的高胆固醇血症患者（n = 21；男/女 = 7/14；HbA1c = 5.3 ± 0.4%）。患者在 12 周的研究期间每天服用 10 mg 依折麦布。在基线和治疗 12 周后，测量了包括血清低密度脂蛋白胆固醇（LDL-C）、非高密度脂蛋白胆固醇（non-HDL-C）、高敏 C 反应蛋白（hs-CRP）和胆固醇合成/吸收相关标志物在内的多种血脂参数。与基线相比，两组患者在接受依折麦布治疗 12 周后，LDL-C、non-HDL-C、菜油固醇和谷固醇水平均显著降低。在校正年龄、性别、吸烟和 BMI 等混杂因素后，T2DM 患者的 LDL-C 和 non-HDL-C 水平降低更为显著（LDL-C 降低 25.1 ± 13.6%，non-HDL-C 降低 20.5 ± 11.2%），而非 T2DM 患者的 LDL-C 和 non-HDL-C 水平降低较少（LDL-C 降低 20.5 ± 7.8%，P < 0.05；non-HDL-C 降低 17.4 ± 7.6%，P < 0.05）。T2DM 患者中，胆甾烷醇水平的降低与 LDL-C 和 non-HDL-C 水平的降低呈显著正相关。综上所述，这些发现表明，与不伴有 T2DM 的高胆固醇血症患者相比，依折麦布可更大程度地降低伴有 T2DM 的高胆固醇血症患者的致动脉粥样硬化脂蛋白水平。
