title: No effect of switching to high-dose rosuvastatin, add-on nicotinic acid, or add-on fenofibrate on serum vitamin D levels in patients with mixed dyslipidemia.
abstract: BACKGROUND
  Low 25-hydroxy-vitamin D [25(OH)VitD] levels may represent a novel cardiovascular disease risk factor. Several statins may increase 25(OH)VitD concentration. The effect of other lipid-lowering drugs is unknown.
  
  
  OBJECTIVE
  To investigate whether switching to high-dose rosuvastatin, add-on-statin nicotinic acid or add-on-statin fenofibrate would alter 25(OH)VitD levels in patients with mixed dyslipidemia who are already on a conventional statin dose.
  
  
  METHODS
  This is a prespecified analysis of a previously published study. Forty-four patients with mixed dyslipidemia not at treatment goal despite treatment with simvastatin 10-40 mg or atorvastatin 10-20 mg or rosuvastatin 5-10 mg were randomly allocated to switch to rosuvastatin 40 mg (n=17), add-on-statin extended release nicotinic acid (ER-NA)/laropiprant (LRPT) (1000/20 mg first four weeks and 2000/40 mg thereafter) (n=14), or add-on-statin micronized fenofibrate (200 mg) for three months. The endpoint for this analysis was between-group difference in changes in 25(OH)VitD levels.
  
  
  RESULTS
  Serum 25(OH)VitD levels did not significantly change in any group. In the switch to the highest dose of rosuvastatin group and the add-on-statin ER-NA/LRPT group there was an insignificant decrease in 25(OH)VitD levels {-4.7% [from 16.8 (3.2-37) to 16.0 (7.9-51.6)] and -14.8% [from 12.8 (2.0-54.8) to 10.9 (2.4-34)], respectively]}, while in the add-on-statin fenofibrate group there was an insignificant increase [+13% (from 14.5 (1.0-42) to 16.4 (4.4-30.4) ng/mL)]. No significant difference between groups was found.
  
  
  CONCLUSIONS
  In patients already on a conventional statin dose, neither switching to high-dose rosuvastatin (40 mg) nor add-on-statin ER-NA/LRPT or fenofibrate were associated with significant changes in 25(OH)VitD serum levels. Hippokratia 2015; 19 (2):136-140.
authors.affiliation: Department of Internal Medicine, Medical School, University of Ioannina, Ioannina, Greece; Department of Child Health, Medical School, University of Ioannina, Ioannina, Greece.
authors.forename: E S
authors.initials: ES
authors.lastname: Makariou
authors.affiliation: Department of Internal Medicine, Medical School, University of Ioannina, Ioannina, Greece.
authors.forename: M
authors.initials: M
authors.lastname: Elisaf
authors.affiliation: Department of Internal Medicine, Medical School, University of Ioannina, Ioannina, Greece.
authors.forename: A
authors.initials: A
authors.lastname: Kei
authors.affiliation: Department of Internal Medicine, Medical School, University of Ioannina, Ioannina, Greece.
authors.forename: A
authors.initials: A
authors.lastname: Challa
authors.affiliation: Mid America Heart Institute, Saint Luke's Hospital, Kansas City, Missouri, U.S.A.
authors.forename: J J
authors.initials: JJ
authors.lastname: DiNicolantonio
authors.affiliation: Department of Internal Medicine, Medical School, University of Ioannina, Ioannina, Greece.
authors.forename: E
authors.initials: E
authors.lastname: Liberopoulos
keywords: cardiovascular disease; fenofibrate; laropiprant; nicotinic acid; rosuvastatin; statins; vitamin D