Differences in synthesis and absorption of cholesterol of two effective lipid-lowering therapies

Brazilian Journal of Medical and Biological Research

S.h. Kasmas²  M.c. Izar²  C.n. França²  S.c. Ramos²  F.t. Moreira²  T. Helfenstein²  R.a. Moreno¹  N.c. Borges¹  A.m. Figueiredo-neto¹  F.a. Fonseca² 

[1] ,Universidade Federal de São Paulo Departamento de Medicina Divisão de CardiologiaSão Paulo SP ,Brasil

关键词: Campesterol;    β-sitosterol;    Desmosterol;    Statin;    Ezetimibe;   

DOI  :  10.1590/S0100-879X2012007500118

来源: SciELO

【 摘 要 】

Effective statin therapy is associated with a marked reduction of cardiovascular events. However, the explanation for full benefits obtained for LDL cholesterol targets by combined lipid-lowering therapy is controversial. Our study compared the effects of two equally effective lipid-lowering strategies on markers of cholesterol synthesis and absorption. A prospective, open label, randomized, parallel design study, with blinded endpoints, included 116 subjects. We compared the effects of a 12-week treatment with 40 mg rosuvastatin or the combination of 40 mg simvastatin/10 mg ezetimibe on markers of cholesterol absorption (campesterol and β-sitosterol), synthesis (desmosterol), and their ratios to cholesterol. Both therapies similarly decreased total and LDL cholesterol, triglycerides and apolipoprotein B, and increased apolipoprotein A1 (P < 0.05 vs baseline for all). Simvastatin/ezetimibe increased plasma desmosterol (P = 0.012 vs baseline), and decreased campesterol and β-sitosterol (P < 0.0001 vs baseline for both), with higher desmosterol (P = 0.007) and lower campesterol and β-sitosterol compared to rosuvastatin, (P < 0.0001, for both). In addition, rosuvastatin increased the ratios of these markers to cholesterol (P < 0.002 vs baseline for all), whereas simvastatin/ezetimibe significantly decreased the campesterol/cholesterol ratio (P = 0.008 vs baseline) and tripled the desmosterol/cholesterol ratio (P < 0.0001 vs baseline). The campesterol/cholesterol and β-sitosterol/cholesterol ratios were lower, whereas the desmosterol/cholesterol ratio was higher in patients receiving simvastatin/ezetimibe (P < 0.0001 vs rosuvastatin, for all). Pronounced differences in markers of cholesterol absorption and synthesis were observed between two equally effective lipid-lowering strategies.

【 授权许可】

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