Context and Objective: Investigating the effects of lipid-lowering drugs on HDL subclasses has shown ambiguous results.This study assessed the effects of ezetimibe, simvastatin, and their combination on HDL subclass distribution.Design and Participants: A single-center randomized parallel 3-group open-label study was performed in 72 healthy menfree of cardiovascular disease with a baseline LDL-cholesterol of 111±630 mg/dl (2.96±0.8 mmol/l) and a baseline HDLcholesterolof 64615 mg/dl (1.76±0.4 mmol/l). They were treated with ezetimibe (10 mg/day, n = 24), simvastatin (40 mg/day, n = 24) or their combination (n = 24) for 14 days. Blood was drawn before and after the treatment period. HDLsubclasses were determined using polyacrylamide gel-tube electrophoresis. Multivariate regression models were used todetermine the influence of treatment and covariates on changes in HDL subclass composition.Results: Baseline HDL subclasses consisted of 33±10% large, 48±66% intermediate and 19±68% small HDL. After adjustingfor baseline HDL subclass distribution, body mass index, LDL-C and the ratio triglycerides/HDL-C, there was a significantincrease in large HDL by about 3.9 percentage points (P,0.05) and a decrease in intermediate HDL by about 3.5 percentagepoints (P,0.01) in both simvastatin-containing treatment arms in comparison to ezetimibe. The parameters obtained afteradditional adjustment for the decrease in LDL-C indicated that about one third to one half of these effects could beexplained by the extent of LDL-C-lowering.Conclusions: In healthy men, treatment with simvastatin leads to favorable effects on HDL subclass composition, which wasnot be observed with ezetimibe. Part of these differential effects may be due to the stronger LDL-C-lowering effects ofsimvastatin.
|Numero di pagine||11|
|Stato di pubblicazione||Published - 2014|
All Science Journal Classification (ASJC) codes