Differences in synthesis and absorption of cholesterol of two effective lipid-lowering therapies

Author(s)

Kasmas, S. H. ^[1] ; Izar, M. C. ^{[1, 2]} ; Franca, C. N. ^[1] ; Ramos, S. C. ^[1] ; Moreira, F. T. ^[1] ; Helfenstein, T. ^{[1, 2]} ; Moreno, R. A. ^[3] ; Borges, N. C. ^[3] ; Figueiredo-Neto, A. M. ^[2] ; Fonseca, F. A. ^{[1, 2]}

Affiliation

^[1] Univ Fed Sao Paulo, Div Cardiol, Dept Med, BR-04039030 Sao Paulo - Brazil

^[2] Inst Nacl Ciencia & Tecnol Fluidos Complexos, Sao Paulo - Brazil

^[3] Synchrophar, Campinas, SP - Brazil

• Document type: Journal article
• Source: Brazilian Journal of Medical and Biological Research; v. 45, n. 11, p. 1095-1101, NOV 2012.
• Web of Science Citations: 9

Abstract

Effective statin therapy is associated with a marked reduction of cardiovascular events. However, the explanation for full benefits obtained for LDL cholesterol targets by combined lipid-lowering therapy is controversial. Our study compared the effects of two equally effective lipid-lowering strategies on markers of cholesterol synthesis and absorption. A prospective, open label, randomized, parallel design study, with blinded endpoints, included 116 subjects. We compared the effects of a 12-week treatment with 40 mg rosuvastatin or the combination of 40 mg simvastatin/10 mg ezetimibe on markers of cholesterol absorption (campesterol and beta-sitosterol), synthesis (desmosterol), and their ratios to cholesterol. Both therapies similarly decreased total and LDL cholesterol, triglycerides and apolipoprotein B, and increased apolipoprotein A1 (P < 0.05 vs baseline for all). Simvastatin/ezetimibe increased plasma desmosterol (P = 0.012 vs baseline), and decreased campesterol and beta-sitosterol (P < 0.0001 vs baseline for both), with higher desmosterol (P = 0.007) and lower campesterol and beta-sitosterol compared to rosuvastatin, (P < 0.0001, for both). In addition, rosuvastatin increased the ratios of these markers to cholesterol (P < 0.002 vs baseline for all), whereas simvastatin/ezetimibe significantly decreased the campesterol/cholesterol ratio (P = 0.008 vs baseline) and tripled the desmosterol/cholesterol ratio (P < 0.0001 vs baseline). The campesterol/cholesterol and beta-sitosterol/cholesterol ratios were lower, whereas the desmosterol/cholesterol ratio was higher in patients receiving simvastatin/ezetimibe (P < 0.0001 vs rosuvastatin, for all). Pronounced differences in markers of cholesterol absorption and synthesis were observed between two equally effective lipid-lowering strategies. (AU)

• FAPESP's process: 08/57685-7 - NICT of Complex Fluids (IFCx)
• Grantee: Antonio Martins Figueiredo Neto
• Support Opportunities: Research Projects - Thematic Grants