title: Effect of two lipid-lowering strategies on high-density lipoprotein function and some HDL-related proteins: a randomized clinical trial.
abstract: BACKGROUND
  The influence of lipid-lowering therapy on high-density lipoprotein (HDL) is incompletely understood. We compared the effect of two lipid-lowering strategies on HDL functions and identified some HDL-related proteins.
  
  
  METHODS
  Thirty two patients were initially screened and HDLs of 21 patients were finally analyzed. Patients were randomized to receive atorvastatin 20 mg (n = 11) or atorvastatin 5 mg/ezetimibe 10 mg combination (n = 10) for 8 weeks. The cholesterol efflux capacity and other anti-inflammatory functions were assessed based on HDLs of the participants before and after treatment. Pre-specified HDL proteins of the same HDL samples were measured.
  
  
  RESULTS
  The post-treatment increase in cholesterol efflux capacities was similar between the groups (35.6% and 34.6% for mono-therapy and combination, respectively, p = 0.60). Changes in nitric oxide (NO) production, vascular cell adhesion molecule-1 (VCAM-1) expression, and reactive oxygen species (ROS) production were similar between the groups. The baseline cholesterol efflux capacity correlated positively with apolipoprotein (apo)A1 and C3, whereas apoA1 and apoC1 showed inverse associations with VCAM-1 expression. The changes in the cholesterol efflux capacity were positively correlated with multiple HDL proteins, especially apoA2.
  
  
  CONCLUSIONS
  Two regimens increased the cholesterol efflux capacity of HDL comparably. Multiple HDL proteins, not limited to apoA1, showed a correlation with HDL functions. These results indicate that conventional lipid therapy may have additional effects on HDL functions with changes in HDL proteins.
  
  
  BACKGROUND
  ClinicalTrials.gov, number NCT02942602 .
authors.affiliation: Division of Cardiology, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.|Cardiovascular Research Institute, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Chan Joo
authors.initials: CJ
authors.lastname: Lee
authors.affiliation: Gachon Cardiovascular Research Institute, Gachon University, Incheon, Korea.
authors.forename: Seungbum
authors.initials: S
authors.lastname: Choi
authors.affiliation: Center for Theragnosis, Biomedical Research Institute, Korea Institute of Science and Technology, Seoul, Korea.|Interdisciplinary program of Integrated Biotechnology, Sogang University, Seoul, Korea.
authors.forename: Dong Huey
authors.initials: DH
authors.lastname: Cheon
authors.affiliation: Center for Theragnosis, Biomedical Research Institute, Korea Institute of Science and Technology, Seoul, Korea.|Department of chemistry, Sookmyung Women's University, Seoul, Korea.
authors.forename: Kyeong Yeon
authors.initials: KY
authors.lastname: Kim
authors.affiliation: Division of Cardiology, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.|Cardiovascular Research Institute, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Eun Jeong
authors.initials: EJ
authors.lastname: Cheon
authors.affiliation: Division of Cardiology, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.|Cardiovascular Research Institute, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Soo-Jin
authors.initials: SJ
authors.lastname: Ann
authors.affiliation: Division of Cardiology, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.|Cardiovascular Research Institute, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Hye-Min
authors.initials: HM
authors.lastname: Noh
authors.affiliation: Division of Cardiology, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.|Cardiovascular Research Institute, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Sungha
authors.initials: S
authors.lastname: Park
authors.affiliation: Division of Cardiology, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.|Cardiovascular Research Institute, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Seok-Min
authors.initials: SM
authors.lastname: Kang
authors.affiliation: Division of Cardiology, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.|Cardiovascular Research Institute, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Donghoon
authors.initials: D
authors.lastname: Choi
authors.affiliation: Center for Theragnosis, Biomedical Research Institute, Korea Institute of Science and Technology, Seoul, Korea. jelee9137@kist.re.kr.
authors.forename: Ji Eun
authors.initials: JE
authors.lastname: Lee
authors.affiliation: Division of Cardiology, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea. shl1106@yuhs.ac.|Cardiovascular Research Institute, Yonsei University College of Medicine, Seoul, Korea. shl1106@yuhs.ac.
authors.forename: Sang-Hak
authors.initials: SH
authors.lastname: Lee
mesh_terms: D000924:Anticholesteremic Agents / Q000494:pharmacology / Q000627:therapeutic use*; D001053:Apolipoproteins / Q000097:blood*; D000069059:Atorvastatin / Q000494:pharmacology / Q000627:therapeutic use*; D008076:Cholesterol, HDL / Q000097:blood*; D004359:Drug Therapy, Combination; D000069438:Ezetimibe / Q000494:pharmacology / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D006937:Hypercholesterolemia / Q000097:blood / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome; D019010:Vascular Cell Adhesion Molecule-1 / Q000097:blood
chemical_list: D000924:Anticholesteremic Agents; D001053:Apolipoproteins; D008076:Cholesterol, HDL; D019010:Vascular Cell Adhesion Molecule-1; D000069059:Atorvastatin; D000069438:Ezetimibe
keywords: Atorvastatin calcium; Cholesterol-efflux regulatory protein; Ezetimibe; Inflammation