title: Ezetimibe combined with standard diet and exercise therapy improves insulin resistance and atherosclerotic markers in patients with metabolic syndrome.
abstract: OBJECTIVE
  Ezetimibe lowers serum lipid levels by inhibiting intestinal absorption of dietary and biliary cholesterol. However, the effect of ezetimibe on insulin resistance remains unclear. The aim of the present study was to examine this issue in patients with metabolic syndrome in local-dwelling Japanese, who were not being treated with lipid-lowering drugs.
  
  
  METHODS
  In 2009, 1,943 participants received a health examination in the Tanushimaru Study, a Japanese cohort of the Seven Countries Study, of whom 490 participants had metabolic syndrome. Among them, 61 participants (41 men and 20 women) were examined in the present study. They were treated with 10 mg of ezetimibe once a day for 24 weeks, combined with standard diet and exercise therapy.
  
  
  RESULTS
  Bodyweight (P < 0.001), body mass index (P < 0.001), systolic blood pressure (P = 0.003), diastolic blood pressure (P < 0.001), triglycerides (P = 0.002), non-high-density lipoprotein cholesterol (P = 0.001), low-density lipoprotein cholesterol (P < 0.001) and homeostasis model assessment of insulin resistance (P = 0.011) significantly decreased after the observational period. There were no statistically significant differences in the effects of ezetimibe between men and women. Univariate analysis showed that the reduction of homeostasis model assessment of insulin resistance was not associated with the improvement of other metabolic components.
  
  
  CONCLUSIONS
  Ezetimibe combined with standard diet and exercise therapy improves not only bodyweight and atherogenic lipid profiles, but also insulin resistance, blood pressure and anthropometric factors in metabolic syndrome in local-dwelling Japanese. Interestingly, the improvement of insulin resistance had no correlation with other metabolic components.
authors.affiliation: Department of Internal Medicine, Division of Cardio-Vascular Medicine Kurume, Japan.
authors.forename: Kyoko
authors.initials: K
authors.lastname: Ohbu-Murayama
authors.affiliation: Department of Community Medicine, Kurume University School of Medicine Kurume, Japan.
authors.forename: Hisashi
authors.initials: H
authors.lastname: Adachi
authors.affiliation: Department of Internal Medicine, Division of Cardio-Vascular Medicine Kurume, Japan.
authors.forename: Yuji
authors.initials: Y
authors.lastname: Hirai
authors.affiliation: Department of Internal Medicine, Division of Cardio-Vascular Medicine Kurume, Japan.
authors.forename: Mika
authors.initials: M
authors.lastname: Enomoto
authors.affiliation: Department of Internal Medicine, Division of Cardio-Vascular Medicine Kurume, Japan.
authors.forename: Ako
authors.initials: A
authors.lastname: Fukami
authors.affiliation: Department of Internal Medicine, Division of Cardio-Vascular Medicine Kurume, Japan.
authors.forename: Aya
authors.initials: A
authors.lastname: Obuchi
authors.affiliation: Department of Internal Medicine, Division of Cardio-Vascular Medicine Kurume, Japan.
authors.forename: Ayako
authors.initials: A
authors.lastname: Yoshimura
authors.affiliation: Department of Internal Medicine, Division of Cardio-Vascular Medicine Kurume, Japan.
authors.forename: Sachiko
authors.initials: S
authors.lastname: Nakamura
authors.affiliation: Department of Internal Medicine, Division of Cardio-Vascular Medicine Kurume, Japan.
authors.forename: Yume
authors.initials: Y
authors.lastname: Nohara
authors.affiliation: Department of Internal Medicine, Division of Cardio-Vascular Medicine Kurume, Japan.
authors.forename: Erika
authors.initials: E
authors.lastname: Nakao
authors.affiliation: Department of Internal Medicine, Division of Cardio-Vascular Medicine Kurume, Japan.
authors.forename: Yoko
authors.initials: Y
authors.lastname: Umeki
authors.affiliation: Department of Internal Medicine, Division of Cardio-Vascular Medicine Kurume, Japan.
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Fukumoto
keywords: Ezetimibe; Insulin resistance; Metabolic syndrome