title: Ezetimibe improves postprandial hyperlipidaemia in patients with type IIb hyperlipidaemia.
abstract: BACKGROUND
  Postprandial hyperlipidaemia is known to be a high-risk factor for atherosclerotic disease because of rapid and lasting accumulations of triglyceride-rich lipoproteins and remnants. The Niemann-Pick C1-Like 1 (NPC1L1) protein acts as an intestinal cholesterol transporter and ezetimibe, which inhibits NPC1L1, has been used in patients with hypercholesterolaemia. We investigated effects of ezetimibe on fasting lipid and lipoprotein profiles and postprandial hyperlipidaemia in patients with type IIb hyperlipidaemia.
  
  
  METHODS
  Ezetimibe 10 mg per day was administered in ten patients with type IIb hyperlipidaemia for 2 months, and lipid and lipoprotein profiles were examined during fasting and after an oral fat loading (OFL) test.
  
  
  RESULTS
  In the fasting state, ezetimibe significantly decreased not only total cholesterol, low density lipoprotein (LDL)-cholesterol and apolipoproteinB-100 (apoB-100) levels but triglycerides (TG), apoB-48 and remnant lipoprotein cholesterol (RemL-C) levels. High performance liquid chromatography analysis showed that ezetimibe decreased cholesterol and TG levels in the very low density lipoprotein (VLDL) and LDL size ranges as well as apoB-100 levels, suggesting a decrease in numbers of VLDL and LDL particles. After OFL, ezetimibe decreased the area under the curve for TG, apoB-48 and RemL-C. Ezetimibe decreased postprandial elevations of cholesterol and TG levels in the chylomicrons (CM) size range, suggesting that the postprandial production of CM particles was suppressed by ezetimibe.
  
  
  CONCLUSIONS
  These findings suggest that ezetimibe improves fasting lipoprotein profiles and postprandial hyperlipidaemia by suppressing intestinal CM production in patients with type IIb hyperlipidaemia and such treatment may prove to be effective in reducing atherosclerosis.
authors.affiliation: Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine, Osaka University, 2-2 Yamada-oka, Suita, Osaka, Japan. masuda@imed2.med.osaka-u.ac.jp
authors.forename: D
authors.initials: D
authors.lastname: Masuda
authors.forename: Y
authors.initials: Y
authors.lastname: Nakagawa-Toyama
authors.forename: K
authors.initials: K
authors.lastname: Nakatani
authors.forename: M
authors.initials: M
authors.lastname: Inagaki
authors.forename: K
authors.initials: K
authors.lastname: Tsubakio-Yamamoto
authors.forename: J C
authors.initials: JC
authors.lastname: Sandoval
authors.forename: T
authors.initials: T
authors.lastname: Ohama
authors.forename: M
authors.initials: M
authors.lastname: Nishida
authors.forename: M
authors.initials: M
authors.lastname: Ishigami
authors.forename: S
authors.initials: S
authors.lastname: Yamashita
mesh_terms: D000924:Anticholesteremic Agents / Q000008:administration & dosage*; D050197:Atherosclerosis / Q000097:blood* / Q000188:drug therapy; D001384:Azetidines / Q000008:administration & dosage*; D000069438:Ezetimibe; D005260:Female; D006801:Humans; D006949:Hyperlipidemias / Q000097:blood* / Q000188:drug therapy; D007564:Japan; D008074:Lipoproteins / Q000097:blood* / Q000187:drug effects; D008297:Male; D019518:Postprandial Period / Q000187:drug effects; D012307:Risk Factors; D014280:Triglycerides / Q000097:blood*
chemical_list: D000924:Anticholesteremic Agents; D001384:Azetidines; D008074:Lipoproteins; D014280:Triglycerides; C030087:lipoprotein triglyceride; D000069438:Ezetimibe