title: The efficacy of Ezetimibe added to ongoing Fibrate-Statin therapy on postprandial lipid profile in the patients with type 2 Diabetes mellitus.
abstract: BACKGROUND
  Postprandial hypertriglyceridemia in diabetes mellitus can be followed by endothelial dysfunction, impaired vascular compliance and increased cardiovascular complications. So focus on better control of postprandial hypertriglyceridemia is as important as controlling fasting triglyceride level in type 2 DM.
  
  
  OBJECTIVE
  We evaluated the effect of ezetimibe adding to fibrate or statin on postprandial hypertriglyceridemia.
  
  
  METHODS
  In a randomized controlled clinical trial, 47 subjects with type 2 diabetes and hypertiglyceridemia were enrolled and divided in three treatment groups including Gemfibrozil 1200mg/d + placebo(group A), Ezetimibe10mg/d + Gemfibrozile 1200mg/d(group B) or Ezetimibe10mg/d + Atorvastatin10mg/d (group C) for a 6- week period. Oral fat loading test were performed in the initiation and also at the end of the study and lipid profile and APOB were measured.
  
  
  RESULTS
  Fasting and postprandial serum triglyceride (TG) decreased significantly with all the three treatment groups with no difference between them in the percent of TG reduction. Although serum total cholesterol decreased significantly in all the three groups of treatment its reduction was more prominent in group C(-38.1% ± 11.2%in group C vs. -16.5% ± 19.6% and -7.2% ± 10.7% in groups B & A respectively, p < 0.0001 ). Fasting serum HDL increased significantly only by Gemfibrozil (23.4% ± 28.4% vs. 6.4% ± 18.9% and 1.8% ± 17.7%, p < 0.05 ). Fasting serum APOB was reduced only in ezetimibe containing groups (B &C).
  
  
  CONCLUSIONS
  Adding ezetimibe to gemfibrozil has no additional effect on reducing postprandial TG but ezetimibe can potentiate the effect of low-dose atorvastatin on lowering TG and LDL-c.
authors.affiliation: Metabolic Diseases Research Centre, Zanjan University of Medical Sciences, Zanjan, Iran. adz.shajari@gmail.com.
authors.forename: Faranak
authors.initials: F
authors.lastname: Sharifi
authors.forename: Nima
authors.initials: N
authors.lastname: Hojeghani
authors.forename: Saeideh
authors.initials: S
authors.lastname: Mazloomzadeh
authors.forename: Zahra
authors.initials: Z
authors.lastname: Shajari