title: Lipid lowering efficacy between morning and evening simvastatin treatment: a randomized double-blind study.
abstract: OBJECTIVE
  To compare lipid-lowering efficacy and high sensitive C-reactive protein (hsCRP) level between morning and evening simvastatin administration in hyperlipidemia subjects.
  
  
  METHODS
  A randomized double blind controlled trial was conducted in 52 dyslipidemia subjects. A group of twenty five subjects received 10 mg simvastatin in the morning and placebo in the evening. The other group of twenty seven subjects received vice versa. Serum lipid profiles were evaluated every 4 weeks for the total course of 12 weeks. High sensitive CRP was measured at the beginning and the end of the study.
  
  
  RESULTS
  Baseline LDL levels were similar in both groups (p = 0.95). The evening simvastatin group had significantly less low density lipoprotein level (LDL) than the morning group at 4 weeks (112 +/- 26.1 mg/dl vs. 136.3 +/- 32 mg/dl, p = 0.001) and 8 weeks after treatment (109.7 +/- 28 mg/dl vs. 129.5 +/- 27 mg/dl, p = 0.006). Difference in LDL after 12th week between two groups was not significant (p = 0.23). Triglyceride and HDL level were not different in both groups. Only evening simvastatin administration could significantly decrease hsCRP (p = 0.03).
  
  
  CONCLUSIONS
  Simvastatin should be taken in the evening. Although lipid profiles were not statistically different in morning and nighttime simvastatin, the inflammatory marker (hsCRP level) is significantly reduced as a result of evening simvastatin administration.
authors.affiliation: Division of Endocrinology, Department of Medicine, Faculty of Medicine, Thammasat University, Pathumthani, Thailand. tthippap@tu.ac.th
authors.forename: Thipaporn
authors.initials: T
authors.lastname: Tharavanij
authors.forename: Sirichai
authors.initials: S
authors.lastname: Wongtanakarn
authors.forename: Nusiri
authors.initials: N
authors.lastname: Lerdvuthisopon
authors.forename: Sugree
authors.initials: S
authors.lastname: Teeraaunkul
authors.forename: Pilasinee
authors.initials: P
authors.lastname: Youngsriphithak
authors.forename: Paskorn
authors.initials: P
authors.lastname: Sritipsukho
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002097:C-Reactive Protein / Q000032:analysis* / Q000187:drug effects; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D006949:Hyperlipidemias / Q000097:blood / Q000188:drug therapy*; D000960:Hypolipidemic Agents / Q000008:administration & dosage*; D008077:Lipoproteins, LDL / Q000097:blood / Q000187:drug effects*; D008297:Male; D008875:Middle Aged; D019821:Simvastatin / Q000008:administration & dosage*; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000960:Hypolipidemic Agents; D008077:Lipoproteins, LDL; D002097:C-Reactive Protein; D019821:Simvastatin