title: Ezetimibe reduces urinary albumin excretion in hypercholesterolaemic type 2 diabetes patients with microalbuminuria.
abstract: OBJECTIVE
  This study investigated the effects of ezetimibe, an inhibitor of intestinal cholesterol absorption, on early phase diabetic nephropathy.
  
  
  METHODS
  A total of 32 hypercholesterolaemic type 2 diabetes patients with microalbuminuria, defined as a urinary albumin excretion (UAE)  30 but < 300 mg/g creatinine, were enrolled. Various clinical and laboratory parameters were determined at baseline and after 6 months of treatment with 10 mg/day ezetimibe.
  
  
  RESULTS
  Ezetimibe treatment significantly decreased glycated haemoglobin (HbA(1c)), low-density lipoprotein-cholesterol  (LDL-C), triglycerides and UAE, and significantly increased high-density lipoprotein-cholesterol and albumin. It also decreased the serum level of monocyte chemoattractant protein-1 (MCP-1), but this difference was not statistically significant. Univariate analyses showed a correlation between  UAE and body mass index, systolic and diastolic blood pressures, HbA(1c), LDL-C, estimated glomerular filtration rate (inverse), creatinine and MCP-1. Since these parameters may be closely correlated with each other, multiple stepwise regression analysis was performed and demonstrated  that HbA(1c) and MCP-1 were independent determinants of UAE.
  
  
  CONCLUSIONS
  Ezetimibe may be a promising therapeutic strategy for improving albumin excretion, partly through its anti-inflammatory properties, and for reducing LDL-C in hypercholesterolaemic type 2 diabetes patients with  microalbuminuria.
authors.affiliation: Division of Nephrology, Department of Internal Medicine, Shinmatsudo Central General Hospital, Chiba, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Nakamura
authors.forename: E
authors.initials: E
authors.lastname: Sato
authors.forename: M
authors.initials: M
authors.lastname: Amaha
authors.forename: Y
authors.initials: Y
authors.lastname: Kawagoe
authors.forename: S
authors.initials: S
authors.lastname: Maeda
authors.forename: H
authors.initials: H
authors.lastname: Inoue
authors.forename: S I
authors.initials: SI
authors.lastname: Yamagishi
mesh_terms: D000418:Albumins / Q000032:analysis; D000419:Albuminuria / Q000188:drug therapy*; D001384:Azetidines / Q000494:pharmacology / Q000627:therapeutic use*; D001794:Blood Pressure; D015992:Body Mass Index; D018932:Chemokine CCL2 / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood*; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000188:drug therapy; D003928:Diabetic Nephropathies / Q000150:complications / Q000188:drug therapy; D000069438:Ezetimibe; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D006937:Hypercholesterolemia / Q000150:complications / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D014280:Triglycerides / Q000097:blood
chemical_list: D000418:Albumins; D001384:Azetidines; D018932:Chemokine CCL2; D008078:Cholesterol, LDL; D000069438:Ezetimibe; D006442:Glycated Hemoglobin; D014280:Triglycerides; C111835:CCL2 protein, human