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

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

Author Kasmas, Soraia Hani Autor UNIFESP Google Scholar
Izar, Maria Cristina de Oliveira Autor UNIFESP Google Scholar
França, Carolina Nunes Autor UNIFESP Google Scholar
Ramos, Silvia Cristina Autor UNIFESP Google Scholar
Moreira, Flávio Tocci Autor UNIFESP Google Scholar
Helfenstein, Tatiana Autor UNIFESP Google Scholar
Moreno, Ronilson Agnaldo Google Scholar
Borges, Ney Carter do Carmo Google Scholar
Figueiredo Neto, Antonio Martins Google Scholar
Fonseca, Francisco Antonio Helfenstein Autor UNIFESP Google Scholar
Institution Universidade Federal de São Paulo (UNIFESP)
Instituto Nacional de Ciência e Tecnologia de Fluidos Complexos
Synchrophar
Abstract 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.
Keywords Campesterol
β-sitosterol
Desmosterol
Statin
Ezetimibe
Language English
Sponsor Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)
Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)
Grant number FAPESP: 2008/55443-6
FAPESP: 2008/52597-2
CNPq: 2008/57685-7
Date 2012-11-01
Published in Brazilian Journal of Medical and Biological Research. Associação Brasileira de Divulgação Científica, v. 45, n. 11, p. 1095-1101, 2012.
ISSN 0100-879X (Sherpa/Romeo, impact factor)
Publisher Associação Brasileira de Divulgação Científica
Extent 1095-1101
Origin http://dx.doi.org/10.1590/S0100-879X2012007500118
Access rights Open access Open Access
Type Article
Web of Science ID WOS:000309470400015
SciELO ID S0100-879X2012001100015 (statistics in SciELO)
URI http://repositorio.unifesp.br/handle/11600/7380

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