Relationships between metabolic syndrome and other baseline factors and the efficacy of ezetimibe/simvastatin and atorvastatin in patients with type 2 diabetes and hypercholesterolemia.
OBJECTIVE
To investigate relationships between baseline factors and treatment-associated efficacy changes in type 2 diabetes.


METHODS
AND METHODS Multivariable analyses of treatment response in 1,229 type 2 diabetic patients with hypercholesterolemia who received ezetimibe/simvastatin or atorvastatin in a randomized double-blind 6-week study.


RESULTS
Increasing age was related to improvements in all lipid assessments. Men had greater triglyceride and non-HDL cholesterol reductions than women, and black/Hispanic patients had less favorable lipid effects than other races/ethnicities. Increasing baseline LDL cholesterol was associated with improvements in most lipids; higher baseline non-HDL cholesterol with improved HDL cholesterol and triglycerides; higher baseline HDL cholesterol with greater non-HDL cholesterol and high-sensitivity C-reactive protein (hs-CRP) reductions; and higher baseline hs-CRP with smaller LDL cholesterol, non-HDL cholesterol, and apolipoprotein B reductions. Patients with high baseline non-HDL cholesterol or triglycerides less frequently attained LDL cholesterol targets. Obesity was inversely related to HDL cholesterol and hs-CRP changes, and higher baseline A1C to smaller apolipoprotein B reductions. Metabolic syndrome was not a significant predictor.


CONCLUSIONS
Treatment responses in type 2 diabetic patients were related to baseline factors, although treatment effects (ezetimibe/simvastatin being more effective than atorvastatin) remained consistent. The presence of predictive factors should be considered in planning lipid-altering therapy.
University of Miami Miller School of Medicine, Miami, Florida, USA. rgoldber@med.miami.edu
Ronald B
RB
Goldberg
John R
JR
Guyton
Theodore
T
Mazzone
Ruth S
RS
Weinstock
Adam B
AB
Polis
Diane
D
Tipping
Joanne E
JE
Tomassini
Andrew M
AM
Tershakovec
D000924:Anticholesteremic Agents / Q000008:administration & dosage; D000069059:Atorvastatin; D001384:Azetidines / Q000008:administration & dosage*; D044383:Black People / Q000706:statistics & numerical data; D002097:C-Reactive Protein / Q000378:metabolism; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy* / Q000208:ethnology; D004338:Drug Combinations; D000069499:Ezetimibe, Simvastatin Drug Combination; D005260:Female; D006538:Heptanoic Acids / Q000008:administration & dosage*; D006630:Hispanic or Latino / Q000706:statistics & numerical data; D006801:Humans; D006937:Hypercholesterolemia / Q000188:drug therapy* / Q000208:ethnology; D008297:Male; D024821:Metabolic Syndrome / Q000188:drug therapy* / Q000208:ethnology; D015999:Multivariate Analysis; D011237:Predictive Value of Tests; D011758:Pyrroles / Q000008:administration & dosage*; D012307:Risk Factors; D019821:Simvastatin / Q000008:administration & dosage*
D000924:Anticholesteremic Agents; D001384:Azetidines; D004338:Drug Combinations; D000069499:Ezetimibe, Simvastatin Drug Combination; D006538:Heptanoic Acids; D011758:Pyrroles; D002097:C-Reactive Protein; D000069059:Atorvastatin; D019821:Simvastatin