Department of Internal Medicine and Clinical Pharmacology, Medical University of Silesia, Katowice, Poland.
Cardiovasc Ther. 2014 Apr;32(2):40-6. doi: 10.1111/1755-5922.12057.
Pleiotropic effects of ezetimibe have only been investigated in a few studies. The aim of this article was to compare the effects of simvastatin and the combined treatment with simvastatin and ezetimibe on low-grade systemic inflammation and plasma levels of selected adipokines in patients with isolated hypercholesterolemia.
The study included 69 patients with elevated cholesterol levels, who were allocated to one of the three groups treated for 12 weeks, respectively, with simvastatin (40 mg daily), simvastatin (40 mg daily) plus ezetimibe (10 mg daily), or placebo. Plasma levels of lipids, apolipoproteins, glucose homeostasis markers, leptin, adiponectin, visfatin, tumor necrosis factor-α (TNF-α), free fatty acids (FFA), and high-sensitive C-reactive protein (hsCRP) were determined on the allocation day and after 12 weeks of therapy.
Apart from improving lipid profile, simvastatin administered alone or in combination with ezetimibe, decreased plasma levels of hsCRP, FFA, leptin, visfatin, and TNF-α, as well as increased plasma levels of adiponectin. The combination therapy was superior to simvastatin in influencing plasma lipids/lipoproteins, hsCRP, FFA, and the investigated adipokines. The effect of the combination therapy, but not of simvastatin, on systemic inflammation and plasma adipokines was stronger in insulin-resistant than in insulin-sensitive subjects.
The obtained results suggest that insulin-resistant patients with hypercholesterolemia and high cardiovascular risk may benefit the most from the combined treatment with simvastatin and ezetimibe.
依折麦布的多效作用仅在少数研究中进行了研究。本文的目的是比较辛伐他汀和辛伐他汀联合依折麦布治疗对单纯高胆固醇血症患者低度全身炎症和选定脂肪因子血浆水平的影响。
该研究纳入了 69 名胆固醇水平升高的患者，他们分别被分配到三组中，分别接受 12 周的治疗，即辛伐他汀（40mg 每日）、辛伐他汀（40mg 每日）加依折麦布（10mg 每日）或安慰剂。在分配日和治疗 12 周后，测定血浆中脂质、载脂蛋白、葡萄糖稳态标志物、瘦素、脂联素、内脂素、肿瘤坏死因子-α（TNF-α）、游离脂肪酸（FFA）和高敏 C 反应蛋白（hsCRP）的水平。
除了改善血脂谱外，单独使用辛伐他汀或与依折麦布联合使用还可降低 hsCRP、FFA、瘦素、内脂素和 TNF-α的血浆水平，并增加脂联素的血浆水平。联合治疗在影响血脂/脂蛋白、hsCRP、FFA 和所研究的脂肪因子方面优于辛伐他汀。联合治疗对全身炎症和血浆脂肪因子的影响在胰岛素抵抗患者中比胰岛素敏感患者更强，但辛伐他汀无此作用。
研究结果表明，患有高胆固醇血症和高心血管风险的胰岛素抵抗患者可能从辛伐他汀和依折麦布联合治疗中获益最大。
