Lipid-lowering therapy does not affect the postprandial drop in high density lipoprotein-cholesterol (HDL-c) plasma levels in obese men with metabolic syndrome: a randomized double blind crossover trial
Lipid-lowering therapy does not affect the postprandial drop in high density lipoprotein-cholesterol (HDL-c) plasma levels in obese men with metabolic syndrome: a randomized double blind crossover trial
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DOI：
10.1111/j.1365-2265.2008.03250.x
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发表时间：
2008-12-01
影响因子：
3.2
通讯作者：
Visseren, Frank L. J.
中科院分区：
文献类型：
--
作者：
Hajer, Gideon R.;Dallinga-Thie, Geesje M.;Visseren, Frank L. J.
代谢综合征患者餐后脂质代谢紊乱，可能增加这些患者心血管风险。在15名不吸烟的男性中进行前瞻性、随机、双盲、交叉试验，比较辛伐他汀80 mg与辛伐他汀/依折麦布10 mg/10 mg治疗6周对餐后HDL-c代谢的影响，肥胖代谢综合征患者（成人治疗组III，ATP III）。仅允许使用研究药物。分别于口服脂肪负荷前后测定高密度脂蛋白胆固醇（HDL-C）、胆固醇酯转移（CET）、胆固醇酯转移蛋白（CETP）和脂联素（adiponectin）。ClinicalTrials.gov NCT 00189085.在禁食过夜后连续禁食期间，血浆HDL-c水平保持稳定。未经治疗、辛伐他汀和辛伐他汀/依折麦布治疗后的前脂肪负荷HDL-c浓度分别为1.15 +/- 0.04、1.16 +/- 0.05和1.11 +/- 0.04 mmol/l。脂肪负荷导致HDL-c血浆水平下降11%; 1.02 +/- 0.05 mmol/l（P < 0.001），这不受任何治疗的影响。两种治疗后，脂肪负荷期间的甘油三酯水平相似。总CET从9.73 +/- 0.70增加至12.20 +/- 0.67 nmol/ml/h（P = 0.004）。脂肪负荷后4小时，无论治疗与否，CETP质量增加，而脂联素水平降低。肥胖代谢综合征患者在脂肪负荷后，HDL-C水平随CET增加而降低。这不受辛伐他汀或辛伐他汀/依折麦布治疗的影响。脂肪负荷后，CETP质量和CET增加，脂联素减少，指向腹内脂肪的潜在作用。餐后HDL-C水平降低可能导致代谢综合征患者在已经低HDL-C水平的基础上心血管风险增加。
The postprandial lipid metabolism in metabolic syndrome patients is disturbed and may add to the increased cardiovascular risk in these patients. It is not known whether postprandial high density lipoprotein-cholesterol (HDL-c) metabolism is also affected and whether this can be influenced by statin and/or ezetimibe treatment.Prospective, randomized, double blind, crossover trial comparing simvastatin 80 mg with simvastatin/ezetimibe 10 mg/10 mg treatment for 6 weeks on postprandial HDL-c metabolism in 15, nonsmoking, male, obese metabolic syndrome patients (Adult Treatment Panel III, ATPIII). Only study medication was allowed. HDL-c concentrations, cholesteryl ester transfer (CET), CET protein (CETP) mass and adiponectin were measured before and after oral fat loading. ClinicalTrials.gov NCT00189085.Plasma HDL-c levels remained stable during continuous fasting following an overnight fast. Pre-fat load HDL-c concentrations without treatment, after simvastatin and simvastatin/ezetimibe treatment were 1.15 +/- 0.04, 1.16 +/- 0.05 and 1.11 +/- 0.04 mmol/l. Fat load induced a 11% drop in HDL-c plasma levels; 1.02 +/- 0.05 mmol/l (P < 0.001) which was not affected by either therapy. Triglyceride levels during fat load were similar after both treatments. Total CET increased from 9.73 +/- 0.70 to 12.20 +/- 0.67 nmol/ml/h (P = 0.004). Four hours after fat loading CETP mass was increased while adiponectin levels were decreased, irrespective of treatment.HDL-c levels decrease as CET increases after fat loading in obese metabolic syndrome patients. This is not influenced by either simvastatin or simvastatin/ezetimibe treatment. After fat loading, CETP mass and CET increased, and adiponectin decreased pointing towards a potential role for intra-abdominal fat. Decreased postprandial HDL-c levels may contribute to the increased cardiovascular risk in metabolic syndrome patients on top of already low HDL-c levels.