Ezetimibe ameliorates metabolic disorders and microalbuminuria in patients with hypercholesterolemia

Aim: ezetimibe,an inhibitor of niemann-pick c1-like 1 protein,has been shown to reduce the intestinal absorption of cholesterol. we investigated whether it also has beneficial effects on metabolic disorder and/or renal insufficiency in patients with hypercholesterolemia. methods: ezetimibe was administered to 38 japanese patients with hypercholesterolemia to obtain appropriate low-density lipoprotein cholesterol (ldl-chol) levels. age- and sex-matched patients with hypercholesterolemia (n = 38) were the controls. we evaluated the effects of ezetimibe before and 4 to 8 weeks after ezetimibe treatment. results: ezetimibe significantly decreased ldl-chol levels and metabolic syndrome-related factors,including body weight,waist circumference,blood pressure; homeostasis model assessment insulin resistance (homa-ir),and urinary albumin excretion,were significantly reduced. in addition,it decreased the level of high-sensitivity c-reactive protein (hs-crp),tumor necrosis factor (tnf)-α,the urinary excretion of 8-hydroxy-2'-deoxyguanosine,a parameter of oxidative stress,and increased the urinary excretion of nitrate and nitrite (nox). in the controls we observed no such changes. excepting the decrease in the serum tnf-α level,the effects of ezetimibe were not correlated with decreased ldl-chol levels. conclusion: ezetimibe ameliorated the status of metabolic syndrome and microalbuminuria,reduced inflammation and oxidative stress,and increased nitric oxide bioavailability in a ldl-chol reduction-dependent and -independent manner.