| Efficacy of cholesterol uptake inhibition added to statin therapy among subjects following a low-carbohydrate diet: a randomized controlled trial. | |
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MedLine Citation:
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PMID: 20435205 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Low-carbohydrate diets are frequently used as part of weight-loss programs. These are typically associated with increased fat intake. Therefore, cholesterol absorption inhibition is a logical therapeutic strategy to lower low-density lipoprotein cholesterol (LDL-C) in subjects following a low-carbohydrate diet. However, the efficacy of cholesterol absorption inhibition added to statin therapy has not been studied in this common clinical setting. METHODS: We performed a randomized controlled trial to compare the effects of ezetimibe on LDL-C when added to simvastatin among subjects following a low-carbohydrate diet. We enrolled 65 subjects who were overweight or obese (body mass index 25-45 kg/m(2)) and had a moderately elevated LDL-C (130-190 mg/dL). During a 4-week diet run-in, subjects were instructed to restrict carbohydrate intake to <30 g/day. Subjects demonstrating adequate adherence to a low-carbohydrate diet (n = 58) were randomized to simvastatin (20 mg) or simvastatin (20 mg) plus ezetimibe (10 mg) for 8 weeks. RESULTS: Body weight decreased by 3.1% (95% CI 2.1%-4.0%, P < .0001), but the magnitude of weight change did not differ between the groups (P = .92). The LDL-C decreased by 32 mg/dL (95% CI 21-42 mg/dL) in the simvastatin arm and 60 mg/dL (95% CI 45-75 mg/dL) in the combined simvastatin-ezetimibe arm (P = .002). This corresponded to a 20.9% reduction (95% CI 14.5%-27.4%) in LDL-C on simvastatin alone, compared with a 37.4% reduction (95% CI 29.3%-45.6%) on simvastatin-ezetimibe (P = .002). A significant 15.8% reduction in triglycerides was observed among enrolled subjects, which did not differ between the groups. CONCLUSIONS: Among subjects following a low-carbohydrate diet, combined statin and cholesterol absorption inhibitor therapy is more effective than statin monotherapy for LDL-C lowering. |
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Authors:
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Julio A Chirinos; Monica M Williams; David B Bregman; Hera Ashfaq; Umar Khayyam; Nayyar Iqbal |
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Publication Detail:
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Type: Journal Article; Randomized Controlled Trial |
Journal Detail:
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Title: American heart journal Volume: 159 ISSN: 1097-6744 ISO Abbreviation: Am. Heart J. Publication Date: 2010 May |
Date Detail:
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Created Date: 2010-05-03 Completed Date: 2010-05-24 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0370465 Medline TA: Am Heart J Country: United States |
Other Details:
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Languages: eng Pagination: 918.e1-6 Citation Subset: AIM; IM |
Copyright Information:
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2010 Mosby, Inc. All rights reserved. |
Affiliation:
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Department of Medicine, University of Pennsylvania and Philadelphia Veterans Affairs Medical Center, USA. julio.chirinos@uphs.upenn.edu |
| Data Bank Information | |
Bank Name/Acc. No.:
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ClinicalTrials.gov/NCT00566267 |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Aged Anticholesteremic Agents / administration & dosage* Azetidines / administration & dosage* Body Weight Diet, Carbohydrate-Restricted* Double-Blind Method Drug Therapy, Combination Female Humans Hydroxymethylglutaryl-CoA Reductase Inhibitors / administration & dosage* Male Middle Aged Prospective Studies Simvastatin / administration & dosage* Triglycerides / blood |
| Chemical | |
Reg. No./Substance:
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0/Anticholesteremic Agents; 0/Azetidines; 0/Hydroxymethylglutaryl-CoA Reductase Inhibitors; 0/Triglycerides; 163222-33-1/ezetimibe; 79902-63-9/Simvastatin |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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