Effects of simvastatin and ezetimibe in lowering low-density lipoprotein cholesterol in subjects with type 1 and type 2 diabetes mellitus. Metab Syndr Relat Disord 2015 Mar;13(2):84-90
Date
12/10/2014Pubmed ID
25490061DOI
10.1089/met.2014.0114Scopus ID
2-s2.0-84923104921 (requires institutional sign-in at Scopus site) 11 CitationsAbstract
OBJECTIVE: Statins are used to lower total cholesterol (TC) and low-density lipoprotein cholesterol (LDL-C) levels among patients with type 1 (T1DM) and type 2 diabetes mellitus (T2DM). However, there are no studies of statin efficacy among T1DM patients. T1DM patients have higher gut cholesterol absorption than synthesis; hence cholesterol absorption inhibitors such as ezetimibe may also be effective in T1DM. Here, we compare the effects of simvastatin and ezetimibe among subjects with T1DM and T2DM.
RESEARCH DESIGN AND METHODS: Subjects with T1DM (n=20, 45% female) or T2DM (n=27, 56% female) were assigned to alternating therapy with simvastatin (40 mg) or ezetimibe (10 mg) for 6 weeks in a crossover design.
RESULTS: Among T2DM subjects, simvastatin lowered TC and LDL-C from the baseline (-25±4% and -40±5%, respectively, P<0.001), whereas ezetimibe was not as effective (-2±4% and -3±5%, respectively). Among T1DM subjects, both statin and ezetimibe showed significant decreases in TC and LDL-C from baseline, although ezetimibe lowered LDL-C much more than simvastatin (-32±12 (P<0.001) and -19±5% (P<0.01), respectively). Effect of simvastatin on LDL-C was much lower among T1DM subjects compared to T2DM subjects (P=0.02).
CONCLUSIONS: This study shows that the cholesterol synthesis inhibitor simvastatin was less effective in lowering LDL-C in T1DM than T2DM subjects, whereas the cholesterol absorption inhibitor ezetimibe was at least as effective in lowering LDL-C as simvastatin among T1DM subjects.
Author List
Ciriacks K, Coly G, Krishnaswami S, Patel SB, Kidambi SAuthor
Srividya Kidambi MD Sr Medical Director, Chief, Professor in the Medicine department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
AdultAged
Anticholesteremic Agents
Azetidines
Body Mass Index
Cholesterol, LDL
Cross-Over Studies
Diabetes Mellitus, Type 1
Diabetes Mellitus, Type 2
Ezetimibe
Female
Humans
Hydroxymethylglutaryl-CoA Reductase Inhibitors
Lipids
Middle Aged
Prospective Studies
Simvastatin
Waist Circumference