Effects of bezafibrate and pravastatin on remnant-like lipoprotein particles and lipoprotein subclasses in type 2 diabetes

Kazama, Hirohito; Usui, Shinichi; Okazaki, Mitsuyo; Hosoi, Takayuki; Ito, Hideki; Orimo, Hajime

doi:10.1016/s0168-8227(02)00243-7

Cited by 25 publications

(24 citation statements)

References 20 publications

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“…In addition, statins induce minor increases in HDL-C levels (by 5-10%) (Chong et al, 2002), consistent with a reduction in CETP activity (Guerin et al, 1995b(Guerin et al, , 2000b and also with stimulation of apoA-I production (Schaefer et al, 1999). As a consequence, statins (atorvastatin and pravastatin) preferentially increase levels of HDL particles of large and medium size and ␣-mobility Schaefer et al, 2002;Kazama et al, 2003;Soedamah-Muthu et al, 2003).…”

Section: Statinsmentioning

confidence: 65%

“…Fenofibrate (Sasaki et al, 2002;Ikewaki et al, 2004), bezafibrate (Miida et al, 2000;Kazama et al, 2003;Ikewaki et al, 2005), and gemfibrozil (Kahri et al, 1993) all selectively increase small and/or medium HDL particle numbers in patients with type 2 diabetes and in hypertriglyceridemic subjects. Remarkably, the increase in small HDL induced by fibrates may attain ϩ168% in subjects with hypertriglyceridemia (Ikewaki et al, 2005).…”

Section: Fibratesmentioning

confidence: 98%

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Functionally Defective High-Density Lipoprotein: A New Therapeutic Target at the Crossroads of Dyslipidemia, Inflammation, and Atherosclerosis

Kontush¹,

Chapman²

2006

Pharmacol Rev

659

594

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Section: Statinsmentioning

confidence: 65%

Section: Fibratesmentioning

confidence: 98%

Functionally Defective High-Density Lipoprotein: A New Therapeutic Target at the Crossroads of Dyslipidemia, Inflammation, and Atherosclerosis

Kontush¹,

Chapman²

2006

Pharmacol Rev

659

594

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“…Analyses were assessed using Stat View 5.0 for Windows (Tokyo, Japan) and STATA version 10.0 (StataCorp, College Station, Texas). On the basis of previous reports, 8,13-15,20, 21 we proposed that treatment with bezafibrate and pravastatin would reduce RLP-C levels in patients with higher RLP-C levels by approximately 40% and 10%, respectively. When baseline median value of RLP-C levels was assumed to be approximately 8 mg/dl, on treatment RLP-C levels was approximately 4.8 mg/dl in patients treated with bezafibrate and 7.2 mg/dl in patients treated with pravastatin, respectively.…”

Section: Sano K Et Almentioning

confidence: 85%

Comparative Study of Bezafibrate and Pravastatin in Patients With Coronary Artery Disease and High Levels of Remnant Lipoprotein

Sano

Nakamura

Hirano

et al. 2010

Circ J

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Background: Remnant lipoproteinemia is a strong risk factor for cardiovascular (CV) diseases. This study examined which of 2 common lipid-lowering drugs (fibrates and statins) is more effective in patients with remnant lipoproteinemia and if lowering remnant lipoprotein levels can reduce CV risk. Methods and Results:Remnant lipoprotein levels were measured by an immunoseparation method (remnantlike lipoprotein particles cholesterol: RLP-C) in 274 patients with coronary artery disease and high RLP-C levels (≥5.0 mg/dl). They were randomly assigned to receive bezafibrate (200-400 mg/day) or pravastatin (10-20 mg/day), and were prospectively followed-up for 1 year or until the occurrence of CV events. Complete follow-up data were obtained in 180 patients. RLP-C levels at 1 year of treatment were reduced more by bezafibrate than pravastatin (−37% and −25% from baseline, respectively). During follow-up, bezafibrate-treated patients had 3 CV events, compared with 12 events in pravastatin-treated patients (P<0.01). In multivariate logistic regression analysis, a decrease in RLP-C level was significantly associated with a reduction in CV events after adjustment for treatment group and changes in levels of other lipids. Conclusions:Bezafibrate therapy decreased RLP-C levels to a greater extent than pravastatin and a decrease in RLP-C level may be associated with a reduction in CV events in patients with high RLP-C levels. Effects of Fibrate and Statin on RLP-C Methods Study PatientsFrom 2003 December to 2005 March, 274 patients with CAD and high levels of RLP-C (≥5.0 mg/dl) at 17 hospitals (Appendix 1) were enrolled in this study. All patients met the following inclusion criteria: (1) total cholesterol (TC) level in fasting serum ≥180 mg/dl but <260 mg/dl; (2) TG level in fasting serum ≥150 mg/dl but <400 mg/dl; (3) presence of CAD based on angiographic evidence of organic diameter stenosis >50% of at least 1 major coronary artery, but patients were included if they had had a significant stenosis previously, which had been reduced to ≤50% after coronary revascularization; and (4) age 35-75 years. If lipid-lowering drugs were being administered at the time of enrollment, RLP-C, TC, high-density lipoprotein-cholesterol (HDL-C) and TG levels were measured after a wash-out period of more than 4 weeks. The exclusion criteria were: (1) acute coronary syndrome within 10 days prior to enrollment; (2) congestive heart failure (New York Heart Association class III or greater);

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“…In contrast, two studies investigating the effects of pravastatin [56] and simvastatin [57] in small cohorts of patients with type 2 diabetes mellitus could not demonstrate a difference in the reduction of large and small LDL particles. There are more data available on the effects of atorvastatin on LDL quality in patients with diabetes, however these are conflicting.…”

Section: Lipid Lowering Agents Targeting Ldl Particle Distributionmentioning

confidence: 76%

Small dense low-density lipoprotein particles: priority as a treatment target in Type 2 diabetes?

Gerber¹,

Spinas²,

Berneis³

2012

Diabetes Management

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During the past two decades, the importance of the quality of low-density lipoprotein (LDL) particles -in addition to its quantity -has become of increasing interest. The risk of cardiovascular events was recognized to be closely linked to a predominance of small, dense LDL particles. In addition, in patients with Type 2 diabetes mellitus, the disease itself and its severity (in particular the degree of insulin resistance) is associated with this subclass of LDL particles. Lipid lowering as well as antihyperglycemic drugs have been evaluated in many studies concerning their effect on LDL particle size. It has increasingly been recognized that a reduction of LDL quantity is not necessarily associated with a beneficial effect on LDL quality. Advances in the understanding of alterations in LDL quality may therefore influence the choice of the therapeutic regimen in patients with diabetes in the future. SummaryDuring the last two decades, the importance of the quality of low-density lipoprotein (LDL) particles -in addition to its quantity -has become of increasing interest. The risk of cardiovascular events was recognized to be closely linked to a predominance of small, dense LDL particles. In addition, in patients with type 2 diabetes mellitus, the disease itself and its severity (in particular the degree of insulin resistance) is associated with this subclass of LDL particles. Lipid lowering as well as antihyperglycemic drugs have been evaluated in many studies concerning their effect on LDL particle size. It has increasingly been recognized that a reduction of LDL quantity is not necessarily associated with a beneficial effect on LDL quality. Advances in the understanding of alterations in LDL quality may therefore influence the choice of the therapeutic regimen in patients with diabetes in the future.

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Effects of bezafibrate and pravastatin on remnant-like lipoprotein particles and lipoprotein subclasses in type 2 diabetes

Cited by 25 publications

References 20 publications

Functionally Defective High-Density Lipoprotein: A New Therapeutic Target at the Crossroads of Dyslipidemia, Inflammation, and Atherosclerosis

Functionally Defective High-Density Lipoprotein: A New Therapeutic Target at the Crossroads of Dyslipidemia, Inflammation, and Atherosclerosis

Comparative Study of Bezafibrate and Pravastatin in Patients With Coronary Artery Disease and High Levels of Remnant Lipoprotein

Small dense low-density lipoprotein particles: priority as a treatment target in Type 2 diabetes?

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