Lowering Effect of Ezetimibe on Small Dense Low-density Lipoproteins in Patients with Type 2 Diabetes: Relationship to Triglyceride-rich Lipoproteins

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  • Hara Noriko
    Department of Diabetes, Metabolism, and Endocrinology, Division of Internal Medicine, Showa University School of Medicine
  • Hayashi Toshiyuki
    Department of Diabetes, Metabolism, and Endocrinology, Division of Internal Medicine, Showa University School of Medicine
  • Ohno Kayoko
    Department of Diabetes, Metabolism, and Endocrinology, Division of Internal Medicine, Showa University School of Medicine
  • Tomoyasu Masako
    Department of Diabetes, Metabolism, and Endocrinology, Division of Internal Medicine, Showa University School of Medicine
  • Terasaki Sayaka
    Department of Diabetes, Metabolism, and Endocrinology, Division of Internal Medicine, Showa University School of Medicine
  • Fukui Tomoyasu
    Department of Diabetes, Metabolism, and Endocrinology, Division of Internal Medicine, Showa University School of Medicine
  • Hirano Tsutomu
    Department of Diabetes, Metabolism, and Endocrinology, Division of Internal Medicine, Showa University School of Medicine

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Other Title
  • 2型糖尿病におけるエゼチミブの小型高密度低比重リポ蛋白低下作用；トリグリセリド—リッチリポ蛋白との関係
  • 診断・治療(食事・運動・薬物) 2型糖尿病におけるエゼチミブの小型高密度低比重リポ蛋白低下作用 : トリグリセリド-リッチリポ蛋白との関係
  • シンダン ・ チリョウ(ショクジ ・ ウンドウ ・ ヤクブツ) 2ガタ トウニョウビョウ ニ オケル エゼチミブ ノ コガタ コウミツド テイヒジュウ リポ タンパク テイカ サヨウ : トリグリセリド-リッチリポ タンパク ト ノ カンケイ

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Abstract

Abnormal metabolism of triglyceride (TG) -rich lipoproteins and a preponderance of potent atherogenic small dense low-density lipoprotein (sdLDL) particles are frequently observed in patients with type 2 diabetes. Ezetimibe (EZ), an inhibitor of cholesterol absorption in the intestines, has been reported to reduce postprandial lipemia and sdLDL. However, the mechanisms underlying the EZ-induced reduction in sdLDL and its relation to changes in TG-rich lipoproteins remain to be elucidated. We herein examined the effects of EZ on sdLDL-C and postprandial changes in TG, apoB48 and RemL-C in type 2 diabetics. Treatment with EZ (10 mg daily for 12 weeks) significantly decreased the fasting levels of TG (24 %), apoB48 (29 %), and RemL-C (37 %). EZ treatment also decreased the levels of LDL-C (19 %) and sdLDL-C (28 %). Meal tolerance tests using test meal A revealed that EZ attenuates the postprandial increase in RemL-C and RemL-C AUC, whereas the level of apolipoprotein B48 remained unaltered. The reduction in postprandial TG and RemL-C was associated with the sdLDL-C level, while the change in apoB48 was not. Given that the RemL-C level primarily reflects the amount of VLDL remnants originating from the liver, the EZ-induced reduction in sdLDL-C is primary attributable to a reduction in VLDL and its remnant, not intestinal chylomicrons.

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