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Ezetimibe Treatment Lowers Indicators of Oxidative Stress in Hypercholesterolemic Subjects with High Oxidative Stress

  • Original Article
  • Published:
Lipids

Abstract

Ezetimibe effectively reduces low-density lipoprotein cholesterol (LDL-C). In this study, we tested the hypothesis that ezetimibe monotherapy may also decrease markers of oxidative stress in subjects with hypercholesterolemia. Subjects with hypercholesterolemia and no evidence of cardiovascular disease were randomly allocated to open-label ezetimibe monotherapy 10 mg/day (EZT group) or therapeutic lifestyle changes (TLC group). At baseline and 12 weeks post-treatment serum lipoprotein and apolipoprotein levels as well as oxidative stress parameters, including oxidized LDL (ox-LDL), 8-isoprostanes (8-epiPGF2a) and reactive oxygen metabolites (d-ROMs) levels, were blindly determined. A total of 60 patients were included; 30 in each group. Despite a significant decrease in ox-LDL levels (by 20.8%, p < 0.001 vs. baseline; p < 0.001 vs. TLC group) in the EZT group no change in the ratio ox-LDL to LDL-C was noticed following ezetimibe treatment. No significant change in 8-epiPGF2a and d-ROMs levels was observed in the EZT group. Of note, a significant decrease in 8-epiPGF2a and d-ROMs levels (by 20.4% and 18.2%, respectively, p < 0.01 vs. baseline for both), was noted among patients in the EZT group who exhibited ‘high oxidative stress’ at baseline. No change in any of oxidative stress parameters was noted in the TLC group. Ezetimibe may decrease markers of oxidative stress in hypercholesterolemic subjects. This benefit may be more profound among patients who exhibit ‘high oxidative stress’ at baseline.

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Abbreviations

ANCOVA:

Analysis of covariance

Apo:

Apolipoprotein

d-ROMs:

Reactive oxygen metabolites

EZT:

Ezetimibe

HDL-C:

High-density lipoprotein cholesterol

HOMA:

Homeostasis model assessment

LDL-C:

Low-density lipoprotein cholesterol

NCEP:

National Cholesterol Education Program

Ox-LDL:

Oxidized low-density lipoprotein

RISCC:

Ratio of ingested saturated fat and cholesterol to calories

TC:

Total cholesterol

TAG:

Triacylglycerol

TLC:

Therapeutic lifestyle changes

8-epiPGF2a:

8-Isoprostane

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Conflict of interest

This study was conducted independently; no company or institution supported it financially.

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Authors and Affiliations

  1. Department of Internal Medicine, Medical School, University of Ioannina, 451 10, Ioannina, Greece

    Michael S. Kostapanos, Athanasia T. Spyrou, Irene F. Gazi, Moses Elisaf & Evangelos N. Liberopoulos

  2. Laboratory of Biochemistry, Department of Chemistry, University of Ioannina, 451 10, Ioannina, Greece

    Constantinos C. Tellis & Alexandros D. Tselepis

Authors
  1. Michael S. Kostapanos
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  2. Athanasia T. Spyrou
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  3. Constantinos C. Tellis
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  4. Irene F. Gazi
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  5. Alexandros D. Tselepis
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  6. Moses Elisaf
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  7. Evangelos N. Liberopoulos
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Corresponding author

Correspondence to Moses Elisaf.

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Kostapanos, M.S., Spyrou, A.T., Tellis, C.C. et al. Ezetimibe Treatment Lowers Indicators of Oxidative Stress in Hypercholesterolemic Subjects with High Oxidative Stress. Lipids 46, 341–348 (2011). https://doi.org/10.1007/s11745-011-3539-z

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  • DOI: https://doi.org/10.1007/s11745-011-3539-z

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