title: Ezetimibe beneficially influences fasting and postprandial triglyceride-rich lipoproteins in type 2 diabetes.
abstract: BACKGROUND
  Type 2 diabetes is associated with atherogenic abnormalities of postprandial triglyceride-rich lipoproteins. This study evaluated whether ezetimibe, by inhibiting intestinal cholesterol absorption, influences chylomicrons and VLDL particles at fasting and after a standard meal.
  
  
  METHODS
  By a double blind cross-over design 15 subjects with type 2 diabetes and hypercholesterolaemia followed in random order a 6-week treatment with ezetimibe 10mg+simvastatin 20 mg (EZE+S) or placebo+simvastatin 20 mg (P+S) and, after a 6-week wash-out period, crossed over to the other treatment (NCT00699023). At the end of each period lipids, apoB-48, and apoB-100 concentrations in plasma and lipoprotein fractions (separated by discontinuous density gradient ultracentrifugation) were determined before and over 6h following a high-fat test meal.
  
  
  RESULTS
  Compared with P+S, EZE+S induced, (a) beside a greater decrease in LDL cholesterol, (b) a significant decrease in chylomicron lipid content both at fasting and postprandially (4.4 ± 2.7 vs. 8.3 ± 8.7 mg/dl × 6 h total AUC for cholesterol, p < 0.05; 18 ± 12 vs. 29 ± 24 mg/dl triglyceride concentrations at 6h, p < 0.05), (c) a significant decrease in chylomicron postprandial apoB-48 (0.03 ± 0.03 vs. 0.09 ± 0.08 mg/l at 4 h, p < 0.05), and (d) significant fasting and postprandial decreases in the cholesterol content of VLDL, IDL, and LDL, as shown by the significant reduction of the cholesterol/triglyceride ratio in these lipoproteins.
  
  
  CONCLUSIONS
  A 6-week treatment with ezetimibe and simvastatin, compared to simvastatin alone, positively influences lipoprotein profile both at fasting and postprandially in type 2 diabetic patients by favouring the production of cholesterol-poor chylomicrons and VLDL particles that have less atherogenic potential.
authors.affiliation: Department of Clinical and Experimental Medicine, Federico II University, Naples, Italy.
authors.forename: Lutgarda
authors.initials: L
authors.lastname: Bozzetto
authors.forename: Giovanni
authors.initials: G
authors.lastname: Annuzzi
authors.forename: Giuseppina Della
authors.initials: GD
authors.lastname: Corte
authors.forename: Lidia
authors.initials: L
authors.lastname: Patti
authors.forename: Paola
authors.initials: P
authors.lastname: Cipriano
authors.forename: Anna
authors.initials: A
authors.lastname: Mangione
authors.forename: Gabriele
authors.initials: G
authors.lastname: Riccardi
authors.forename: Angela A
authors.initials: AA
authors.lastname: Rivellese
mesh_terms: D000924:Anticholesteremic Agents / Q000494:pharmacology*; D001384:Azetidines / Q000008:administration & dosage*; D001786:Blood Glucose / Q000378:metabolism; D002499:Centrifugation, Density Gradient; D002784:Cholesterol / Q000378:metabolism; D002914:Chylomicrons / Q000378:metabolism; D018592:Cross-Over Studies; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000188:drug therapy*; D004311:Double-Blind Method; D000069438:Ezetimibe; D005215:Fasting; D005260:Female; D006801:Humans; D008079:Lipoproteins, VLDL / Q000097:blood*; D008297:Male; D008875:Middle Aged; D010919:Placebos; D019518:Postprandial Period; D019821:Simvastatin / Q000008:administration & dosage; D013997:Time Factors; D014280:Triglycerides / Q000097:blood*
chemical_list: D000924:Anticholesteremic Agents; D001384:Azetidines; D001786:Blood Glucose; D002914:Chylomicrons; D008079:Lipoproteins, VLDL; D010919:Placebos; D014280:Triglycerides; D002784:Cholesterol; D019821:Simvastatin; D000069438:Ezetimibe