Federici Massimo
University of Rome "Tor Vergata", Department of Systems Medicine and Center for Atherosclerosis "Policlinico Tor Vergata", Rome, Italy.
Atheroscler Suppl. 2015 Feb;17:17-22. doi: 10.1016/S1567-5688(15)50005-6.
Ezetimibe exerts multiple favorable effects on the lipoprotein profile and reduces some inflammatory markers. Decreasing cholesterol synthesis with statin treatment can cause a compensatory increase in cholesterol absorption that reduces the efficacy of statin therapy, whereas addition of a cholesterol absorption inhibitor can improve outcomes. Recent evidence suggests a beneficial effect on atherosclerosis. In patients with diabetes, the effect of insulin resistance on low-density lipoprotein metabolism combined with the effect of hyperglycemia on cholesterol absorption may further diminish the favorable effects of statins. Further analysis is needed also to determine whether the stronger effects of ezetimibe seen in patients with diabetes are a consequence of an interaction of the drug with specific mechanisms.
依折麦布对脂蛋白谱具有多种有益作用，并能降低一些炎症标志物。他汀类药物治疗降低胆固醇合成可导致胆固醇吸收代偿性增加，从而降低他汀类药物治疗的疗效，而添加胆固醇吸收抑制剂可改善治疗效果。最近的证据表明其对动脉粥样硬化有有益作用。在糖尿病患者中，胰岛素抵抗对低密度脂蛋白代谢的影响以及高血糖对胆固醇吸收的影响可能会进一步削弱他汀类药物的有益作用。还需要进一步分析以确定在糖尿病患者中观察到的依折麦布更强的作用是否是该药物与特定机制相互作用的结果。
