Yamaguchi Satoshi, Oba Kageyuki, Higa Moritake, Arasaki Osamu, Shimabukuro Michio
Department of Diabetes, Endocrinology and Metabolism, School of Medicine, Fukushima Medical University, 1 Hikarigaoka, Fukushima 960-1247, Japan.
Department of Cardiology, Nakagami Hospital, 610 Noborikawa, Okinawa 904-2195, Japan.
J Clin Med. 2020 Jun 1;9(6):1675. doi: 10.3390/jcm9061675.
Ezetimibe reduces cardiovascular risk by lowering the levels of low-density lipoprotein cholesterol (LDL-C). However, there is limited information regarding the factors associated with ezetimibe-mediated LDL-C reduction. We investigated the factors associated with LDL-C reduction after ezetimibe administration in Japanese patients with or without type 2 diabetes mellitus (T2DM). This single-center retrospective observational study enrolled a total of 266 consecutive ezetimibe-naïve patients, of which 154 were excluded because of either switching from statin or fenofibrate to ezetimibe (n = 52) or ezetimibe discontinuation (n = 102). Finally, 112 patients were eligible for analysis. To identify the factors influencing LDL-C levels, univariate and multivariate linear regression analyses were performed after 52 weeks of ezetimibe treatment. Overall, advanced age, T2DM, and high baseline LDL-C were significantly associated with a greater decrease in LDL-C levels. In the non-T2DM group, advanced age and high baseline LDL-C were associated with greater decrease in LDL-C levels. In the T2DM group, baseline LDL-C was the only factor that influenced the change in LDL-C levels. Advanced age was significantly associated with higher LDL-C reduction in non-T2DM patients, but not in T2DM patients. Ezetimibe use might be beneficial in older patients without T2DM. The lack of association between age and the LDL-C lowering effect by ezetimibe in patients with T2DM may be due to yet unknown mechanism except low statistical power.
依折麦布通过降低低密度脂蛋白胆固醇（LDL-C）水平来降低心血管疾病风险。然而，关于与依折麦布介导的LDL-C降低相关的因素的信息有限。我们调查了日本2型糖尿病（T2DM）患者和非T2DM患者服用依折麦布后与LDL-C降低相关的因素。这项单中心回顾性观察研究共纳入了266例既往未使用过依折麦布的连续患者，其中154例因从他汀类药物或非诺贝特转换为依折麦布（n = 52）或停用依折麦布（n = 102）而被排除。最终，112例患者符合分析条件。为了确定影响LDL-C水平的因素，在依折麦布治疗52周后进行了单因素和多因素线性回归分析。总体而言，高龄、T2DM和高基线LDL-C与LDL-C水平的更大降低显著相关。在非T2DM组中，高龄和高基线LDL-C与LDL-C水平的更大降低相关。在T2DM组中，基线LDL-C是影响LDL-C水平变化的唯一因素。高龄与非T2DM患者更高的LDL-C降低显著相关，但与T2DM患者无关。在无T2DM的老年患者中使用依折麦布可能有益。T2DM患者年龄与依折麦布降低LDL-C效果之间缺乏关联可能是由于除统计功效低之外的未知机制。
