Diabetes & Metabolism Journal

Original Articles

Clinical Diabetes & Therapeutics
Comparison of the Efficacy of Rosuvastatin Monotherapy 20 mg with Rosuvastatin 5 mg and Ezetimibe 10 mg Combination Therapy on Lipid Parameters in Patients with Type 2 Diabetes Mellitus: You-Cheol Hwang, Ji Eun Jun, In-Kyung Jeong, Kyu Jeung Ahn, Ho Yeon Chung; Diabetes Metab J. 2019;43(5):582-589. Published online January 16, 2019; DOI: https://doi.org/10.4093/dmj.2018.0124

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Background

The apolipoprotein B/A1 (apoB/A1) ratio is a stronger predictor of future cardiovascular disease than is the level of conventional lipids. Statin and ezetimibe combination therapy have shown additional cardioprotective effects over statin monotherapy.

Methods

This was a single-center, randomized, open-label, active-controlled study in Korea. A total of 36 patients with type 2 diabetes mellitus were randomized to either rosuvastatin monotherapy (20 mg/day, n=20) or rosuvastatin/ezetimibe (5 mg/10 mg/day, n=16) combination therapy for 6 weeks.

Results

After the 6-week treatment, low density lipoprotein cholesterol (LDL-C) and apoB reduction were comparable between the two groups (−94.3±15.4 and −62.0±20.9 mg/dL in the rosuvastatin group, −89.9±22.7 and −66.8±21.6 mg/dL in the rosuvastatin/ezetimibe group, P=0.54 and P=0.86, respectively). In addition, change in apoB/A1 ratio (−0.44±0.16 in the rosuvastatin group and −0.47±0.25 in the rosuvastatin/ezetimibe group, P=0.58) did not differ between the two groups. On the other hand, triglyceride and free fatty acid (FFA) reductions were greater in the rosuvastatin/ezetimibe group than in the rosuvastatin group (−10.5 mg/dL [interquartile range (IQR), −37.5 to 29.5] and 0.0 µEq/L [IQR, −136.8 to 146.0] in the rosuvastatin group, −49.5 mg/dL [IQR, −108.5 to −27.5] and −170.5 µEq/L [IQR, −353.0 to 0.8] in the rosuvastatin/ezetimibe group, P=0.010 and P=0.049, respectively). Both treatments were generally well tolerated, and there were no differences in muscle or liver enzyme elevation.

Conclusion

A 6-week combination therapy of low-dose rosuvastatin and ezetimibe showed LDL-C, apoB, and apoB/A1 ratio reduction comparable to that of high-dose rosuvastatin monotherapy in patients with type 2 diabetes mellitus. Triglyceride and FFA reductions were greater with the combination therapy than with rosuvastatin monotherapy.

Citations

Citations to this article as recorded by

Moderate-Intensity Rosuvastatin/Ezetimibe Combination versus Quadruple-Dose Rosuvastatin Monotherapy: A Meta-Analysis and Systemic Review
Yura Kang, Jung Mi Park, Sang-Hak Lee
Yonsei Medical Journal.2024; 65(1): 19. CrossRef
A Comparison of Rosuvastatin Monotherapy and Rosuvastatin Plus Ezetimibe Combination Therapy in Patients With Type 2 Diabetes: A Meta-Analysis of Randomized Controlled Trials
Samuel K Dadzie, Godfrey Tabowei, Mandeep Kaur, Saeed Ahmed, Aayushi Thakur, Khaldoun Khreis, Monika Bai, Adil Amin
Cureus.2024;[Epub] CrossRef
Combination Therapy of Ezetimibe and Rosuvastatin for Dyslipidemia: Current Insights
Maya R Chilbert, Dylan VanDuyn, Sara Salah, Collin M Clark, Qing Ma
Drug Design, Development and Therapy.2022; Volume 16: 2177. CrossRef
Ezetimibe and diabetes mellitus:a new strategy for lowering cholesterol
V.A. Serhiyenko, A.A. Serhiyenko
INTERNATIONAL JOURNAL OF ENDOCRINOLOGY (Ukraine).2022; 18(5): 302. CrossRef
The Effect of Rosuvastatin on Plasma/Serum Levels of High-Sensitivity C-Reactive Protein, Interleukin-6, and D-Dimer in People Living with Human Immunodeficiency Virus: A Systematic Review and Meta-Analysis
Akililu Alemu Ashuro, Yin-Guang Fan, Yuan-Sheng Fu, Dong-Sheng Di, Napoleon Bellua Sam, Hai-Feng Pan, Dong-Qing Ye
AIDS Research and Human Retroviruses.2021; 37(11): 821. CrossRef
Comparison of the Efficacy and Safety of Rosuvastatin/Ezetimibe Combination Therapy and Rosuvastatin Monotherapy on Lipoprotein in Patients With Type 2 Diabetes: Multicenter Randomized Controlled Study
Jiwoo Lee, You-Cheol Hwang, Woo Je Lee, Jong Chul Won, Kee-Ho Song, Cheol-Young Park, Kyu Jeung Ahn, Joong-Yeol Park
Diabetes Therapy.2020; 11(4): 859. CrossRef
Comparison of Renal Effects of Ezetimibe–Statin Combination versus Statin Monotherapy: A Propensity-Score-Matched Analysis
Jaehyun Bae, Namki Hong, Byung-Wan Lee, Eun Seok Kang, Bong-Soo Cha, Yong-ho Lee
Journal of Clinical Medicine.2020; 9(3): 798. CrossRef
Combined use of rosuvastatin and ezetimibe improves hepatic steatosis in patients with dyslipidemia
Won Dong Lee, Beom Kyung Kim, Jun Yong Park, Do Young Kim, Sang Hoon Ahn, Kwang-Hyub Han, Seung Up Kim
European Journal of Gastroenterology & Hepatology.2020; 32(12): 1538. CrossRef
Influence of rosuvastatin dose on total fatty acids and free fatty acids in plasma
Cristian I. Ciucanu, Sonia Olariu, Daliborca C. Vlad, Victor Dumitraşcu
Medicine.2020; 99(48): e23356. CrossRef
The effect of switching from statin-monotherapy to statin/ezetimibe combination therapy on lipid profiles in patients with type 2 diabetes and dyslipidemia: a multicenter open-label study (EUCLID)
Mitsuhide Takeshita, Atsushi Tanaka, Atsushi Kawaguchi, Keiko Sato, Shigeru Toyoda, Teruo Inoue, Koichi Node
Vascular Failure.2020; 4(1): 22. CrossRef
Response: Comparison of the Efficacy of Rosuvastatin Monotherapy 20 mg with Rosuvastatin 5 mg and Ezetimibe 10 mg Combination Therapy on Lipid Parameters in Patients with Type 2 Diabetes Mellitus (Diabetes Metab J 2019;43:582–9)
You-Cheol Hwang
Diabetes & Metabolism Journal.2019; 43(6): 915. CrossRef
Letter: Comparison of the Efficacy of Rosuvastatin Monotherapy 20 mg with Rosuvastatin 5 mg and Ezetimibe 10 mg Combination Therapy on Lipid Parameters in Patients with Type 2 Diabetes Mellitus (Diabetes Metab J2019;43:582–9)
Tae Seo Sohn
Diabetes & Metabolism Journal.2019; 43(6): 909. CrossRef
Changes in Plasma Free Fatty Acids Associated with Type-2 Diabetes
Amélie I. S. Sobczak, Claudia A. Blindauer, Alan J. Stewart
Nutrients.2019; 11(9): 2022. CrossRef

Genetics
APO A2 -265T/C Polymorphism Is Associated with Increased Inflammatory Responses in Patients with Type 2 Diabetes Mellitus: Fariba Koohdani, Haleh Sadrzadeh-Yeganeh, Mahmoud Djalali, Mohammadreza Eshraghian, Elham Zamani, Gity Sotoudeh, Mohammad-Ali Mansournia, Laleh Keramat; Diabetes Metab J. 2016;40(3):222-229. Published online June 20, 2016; DOI: https://doi.org/10.4093/dmj.2016.40.3.222

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12 Web of Science
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Abstract PDF PubReader

Background

Apolipoprotein A2 (APO A2) is the second most abundant structural apolipoprotein in high density lipoprotein. Several studies have examined the possible effect of APO A2 on atherosclerosis incidence. Due to the role of inflammation in atherosclerosis, we aimed to determine the relationship between APO A2 -265T/C polymorphism and inflammation as a risk factor in type 2 diabetes mellitus (T2DM) patients.

Methods

In total, 180 T2DM patients, with known APO A2 -265T/C polymorphism, were recruited for this comparative study and were grouped equally based on their genotypes. Dietary intakes, anthropometric parameters, lipid profile, and inflammatory markers (i.e., pentraxin 3 [PTX3], high-sensitivity C-reactive protein [hs-CRP], and interleukin 18) were measured. The data were analyzed using an independent t-test, a chi-square test, and the analysis of covariance.

Results

After adjusting for confounding factors, in the entire study population and in the patients with or without obesity, the patients with the CC genotype showed higher hs-CRP (P=0.001, P=0.008, and P=0.01, respectively) and lower PTX3 (P=0.01, P=0.03, and P=0.04, respectively) in comparison with the T allele carriers. In the patients with the CC genotype, no significant differences were observed in the inflammatory markers between the obese or non-obese patients. However, regarding the T allele carriers, the plasma hs-CRP level was significantly higher in the obese patients compared to the non-obese patients (P=0.01).

Conclusion

In the T2DM patients, the CC genotype could be considered as a risk factor and the T allele as a protective agent against inflammation, which the latter effect might be impaired by obesity. Our results confirmed the anti-atherogenic effect of APO A2, though more studies are required to establish this effect.

Citations

Citations to this article as recorded by

Proteomic Profiling of Extracellular Vesicles Isolated from Plasma and Peritoneal Exudate in Mice Induced by Crotalus scutulatus scutulatus Crude Venom and Its Purified Cysteine-Rich Secretory Protein (Css-CRiSP)
Armando Reyes, Joseph D. Hatcher, Emelyn Salazar, Jacob Galan, Anton Iliuk, Elda E. Sanchez, Montamas Suntravat
Toxins.2023; 15(7): 434. CrossRef
ApoA2–256T > C polymorphism interacts with Healthy Eating Index, Dietary Quality Index-International and Dietary Phytochemical Index to affect biochemical markers among type 2 diabetic patients
Zahra Esmaeily, Gity Sotoudeh, Masoumeh Rafiee, Fariba Koohdani
British Journal of Nutrition.2022; 127(9): 1343. CrossRef
Interaction between Apo A-II –265T > C polymorphism and dietary total antioxidant capacity on some oxidative stress and inflammatory markers in patients with type 2 diabetes mellitus
Banafsheh Jafari Azad, Mehdi Yaseri, Elnaz Daneshzad, Fariba Koohdani
British Journal of Nutrition.2022; 128(1): 13. CrossRef
Deletion allele of Apo B gene is associated with higher inflammation, oxidative stress and dyslipidemia in obese type 2 diabetic patients: an analytical cross-sectional study
Nasim Mokhtary, Seyedeh Neda Mousavi, Gity Sotoudeh, Mostafa Qorbani, Maryam Dehghani, Fariba Koohdani
BMC Endocrine Disorders.2022;[Epub] CrossRef
Interaction between Apo A-II -265T>C polymorphism and dietary total antioxidant capacity on some anthropometric indices and serum lipid profile in patients with type 2 diabetes mellitus
Banafsheh Jafari Azad, Mehdi Yaseri, Elnaz Daneshzad, Fariba Koohdani
Journal of Nutritional Science.2021;[Epub] CrossRef
A personalised diet study: The interaction between ApoA2 −265T > C polymorphism and dietary inflammatory index on oxidative and inflammatory markers and lipid profile in patients with type 2 diabetes mellitus: A cross‐sectional study
Elmira Karimi, Pourya Tondkar, Gity Sotoudeh, Mostafa Qorbani, Masoumeh Rafiee, Fariba Koohdani
International Journal of Clinical Practice.2021;[Epub] CrossRef
Interaction between the dietary indices and PPAR‐γ Pro12Ala gene variants on cardiovascular risk factors in patients with type 2 diabetes mellitus
Faezeh Abaj, Gity Sotoudeh, Elmira Karimi, Masoumeh Rafiee, Fariba Koohdani
International Journal of Clinical Practice.2021;[Epub] CrossRef
A Genetic Score of Predisposition to Low-Grade Inflammation Associated with Obesity May Contribute to Discern Population at Risk for Metabolic Syndrome
Sebastià Galmés, Margalida Cifre, Andreu Palou, Paula Oliver, Francisca Serra
Nutrients.2019; 11(2): 298. CrossRef
Study of the relationship between APOA-II −265T>C polymorphism and HDL function in response to weight loss in overweight and obese type 2 diabetic patients
Masoumeh Moradi, Maryam Mahmoudi, Ahmad Saedisomeolia, Mohammad Ali Mansournia, Roxana Zahirihashemi, Fariba Koohdani
Clinical Nutrition.2018; 37(3): 965. CrossRef
Apolipoprotein A-II induces acute-phase response associated AA amyloidosis in mice through conformational changes of plasma lipoprotein structure
Mu Yang, Yingye Liu, Jian Dai, Lin Li, Xin Ding, Zhe Xu, Masayuki Mori, Hiroki Miyahara, Jinko Sawashita, Keiichi Higuchi
Scientific Reports.2018;[Epub] CrossRef
Prenatal Exposure to Lipopolysaccharide Induces PTX3 Expression and Results in Obesity in Mouse Offspring
Shugang Qin, Xin Chen, Meng Gao, Jianzhi Zhou, Xiaohui Li
Inflammation.2017; 40(6): 1847. CrossRef

The Association between Apolipoprotein A-II and Metabolic Syndrome in Korean Adults: A Comparison Study of Apolipoprotein A-I and Apolipoprotein B: Dong Won Yi, Dong Wook Jeong, Sang Yeoup Lee, Seok Man Son, Yang Ho Kang; Diabetes Metab J. 2012;36(1):56-63. Published online February 17, 2012; DOI: https://doi.org/10.4093/dmj.2012.36.1.56

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Abstract PDF PubReader

Background

Apolipoprotein A-II (apoA-II) is the second-most abundant apolipoprotein in human high-density lipoprotein and its role in cardio metabolic risk is not entirely clear. It has been suggested to have poor anti-atherogenic or even pro-atherogenic properties, but there are few studies on the possible role of apoA-II in Asian populations. The aim of this study is to evaluate the role of apoA-II in metabolic syndrome (MetS) compared with apolipoprotein A-I (apoA-I) and apolipoprotein B (apoB) in Korean adults.

Methods

We analyzed data from 244 adults who visited the Center for Health Promotion in Pusan National University Yangsan Hospital for routine health examinations.

Results

The mean apoB level was significantly higher, and the mean apoA-I level was significantly lower, in MetS; however, there was no significant difference in apoA-II levels (30.5±4.6 mg/dL vs. 31.2±4.6 mg/dL, P=0.261). ApoA-II levels were more positively correlated with apoA-I levels than apoB levels. ApoA-II levels were less negatively correlated with homocysteine and high sensitivity C-reactive protein levels than apoA-I levels. The differences in MetS prevalence from the lowest to highest quartile of apoA-II were not significant (9.0%, 5.7%, 4.9%, and 6.6%, P=0.279). The relative risk of the highest quartile of apoA-II compared with the lowest quartile also was not significantly different (odds ratio, 0.96; 95% confidence interval, 0.95 to 1.04; P=0.956).

Conclusion

Compared with apoA-I (negative association with MetS) and apoB (positive association with MetS) levels, apoA-II levels did not show any association with MetS in this study involving Korean adults. However, apoA-II may have both anti-atherogenic and pro-atherogenic properties.

Citations

Citations to this article as recorded by

Association of apolipoproteins and lipoprotein(a) with metabolic syndrome: a systematic review and meta-analysis
Juan R. Ulloque-Badaracco, Ali Al-kassab-Córdova, Enrique A. Hernandez-Bustamante, Esteban A. Alarcon-Braga, Miguel Huayta-Cortez, Ximena L. Carballo-Tello, Rosa A. Seminario-Amez, Percy Herrera-Añazco, Vicente A. Benites-Zapata
Lipids in Health and Disease.2023;[Epub] CrossRef
Interaction between Apo A-II –265T > C polymorphism and dietary total antioxidant capacity on some oxidative stress and inflammatory markers in patients with type 2 diabetes mellitus
Banafsheh Jafari Azad, Mehdi Yaseri, Elnaz Daneshzad, Fariba Koohdani
British Journal of Nutrition.2022; 128(1): 13. CrossRef
Dietary acid load modifies the effects of ApoA2–265 T > C polymorphism on lipid profile and serum leptin and ghrelin levels among type 2 diabetic patients
Faezeh Abaj, Zahra Esmaeily, Zeinab Naeini, Masoumeh Rafiee, Fariba Koohdani
BMC Endocrine Disorders.2022;[Epub] CrossRef
Can biomarkers be used to improve diagnosis and prediction of metabolic syndrome in childhood cancer survivors? A systematic review
Vincent G. Pluimakers, Selveta S. van Santen, Marta Fiocco, Marie‐Christine E. Bakker, Aart J. van der Lelij, Marry M. van den Heuvel‐Eibrink, Sebastian J. C. M. M. Neggers
Obesity Reviews.2021;[Epub] CrossRef
Decreased Antiatherogenic Protein Levels are Associated with Aneurysm Structure Alterations in MR Vessel Wall Imaging
Daizo Ishii, Toshinori Matsushige, Shigeyuki Sakamoto, Koji Shimonaga, Yuji Akiyama, Takahito Okazaki, Jumpei Oshita, Kaoru Kurisu
Journal of Stroke and Cerebrovascular Diseases.2019; 28(8): 2221. CrossRef
Low levels of ApoA1 improve risk prediction of type 2 diabetes mellitus
Xing Wu, Zhexin Yu, Wen Su, Daniel A. Isquith, Moni B. Neradilek, Ning Lu, Fusheng Gu, Hongwei Li, Xue-Qiao Zhao
Journal of Clinical Lipidology.2017; 11(2): 362. CrossRef
Apolipoprotein A2 −265 T>C polymorphism interacts with dietary fatty acids intake to modulate inflammation in type 2 diabetes mellitus patients
Laleh Keramat, Haleh Sadrzadeh-Yeganeh, Gity Sotoudeh, Elham Zamani, Mohammadreza Eshraghian, Anahita Mansoori, Fariba Koohdani
Nutrition.2017; 37: 86. CrossRef
APO A2 -265T/C Polymorphism Is Associated with Increased Inflammatory Responses in Patients with Type 2 Diabetes Mellitus
Fariba Koohdani, Haleh Sadrzadeh-Yeganeh, Mahmoud Djalali, Mohammadreza Eshraghian, Elham Zamani, Gity Sotoudeh, Mohammad-Ali Mansournia, Laleh Keramat
Diabetes & Metabolism Journal.2016; 40(3): 222. CrossRef
Association between ApoA-II -265T/C polymorphism and oxidative stress in patients with type 2 diabetes mellitus
Fariba Koohdani, Haleh Sadrzadeh-Yeganeh, Mahmoud Djalali, Mohammadreza Eshraghian, Laleh Keramat, Mohammad-Ali Mansournia, Elham Zamani
Journal of Diabetes and its Complications.2015; 29(7): 908. CrossRef
Anti-inflammatory and cholesterol-reducing properties of apolipoprotein mimetics: a review
C. Roger White, David W. Garber, G.M. Anantharamaiah
Journal of Lipid Research.2014; 55(10): 2007. CrossRef

Associations between ApoB/ApoA-I Ratios and Metabolic Syndrome and its Components in Patients with Type 2 Diabetes.: Jung Eun Kim, Wha Young Kim, Yoon Jung Lee, Ji Eun Park, Young Ju Choi, Kap Bum Huh, Ji Yun Hwang; Korean Diabetes J. 2009;33(2):143-154. Published online April 1, 2009; DOI: https://doi.org/10.4093/kdj.2009.33.2.143

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Abstract PDF

BACKGROUND
The Apolipoprotein B/apolipoprotein A-I ratio (apoB/apoA-I) is a powerful clinical indicator of metabolic syndrome. However, few studies have searched for an association between ApoB/ApoA-I and metabolic syndrome in Korean patients with type 2 diabetes. We investigated the relation between ApoB/ApoA-I and the risk of metabolic syndrome and its components. METHODS: Subjects were 812 (424 males and 388 females) Korean patients who were being treated for type 2 diabetes at Huh's Diabetes Center in Seoul. The patients were classified into quartiles (lowest:Q1-highest:Q4) of ApoB/ApoA-I by gender. Anthropometric and hematological characteristics and dietary intake using a food frequency questionnaire were assessed. RESULTS: The prevalence of metabolic syndrome in our sample was 47.9% in males and 66.5% in females. The odds ratios (OR) for metabolic syndrome and for having its components were significantly increased from Q2 to Q4 quartiles of ApoB/ApoA-I in males (OR = 5.37; 95% CI = 2.98-9.65 and OR = 7.41; 95% CI = 4.04-13.6) and females (OR = 2.57; 95% CI = 1.28-5.15 and OR = 8.49; 95% CI = 4.28-16.8). These trends withstood adjustment for age, duration of type 2 diabetes, fasting blood glucose levels, and macronutrient intake both in males (OR = 5.24; 95% CI = 2.80-9.24 and OR = 7.98; 95% CI = 4.09-15.6) and in females (OR=4.41; 95% CI = 2.26-8.61 and OR = 8.29; 95% CI = 3.85-17.8). CONCLUSION: ApoB/ApoA-I appeared to be independently associated with risk of having metabolic syndrome and its components in Korean patients with type 2 diabetes after adjustment for putative risk factors including macronutrient intake, a particularly important lifestyle factor for patients with type 2 diabetes. A follow-up study of this population should evaluate the mechanisms underlying the relation between ApoB/ApoA-I and metabolic syndrome and its components.

Citations

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Association between dietary flavanones intake and lipid profiles according to the presence of metabolic syndrome in Korean women with type 2 diabetes mellitus
Ji Soo Oh, Hyesook Kim, Aswathy Vijayakumar, Oran Kwon, Young Ju Choi, Kap Bum Huh, Namsoo Chang
Nutrition Research and Practice.2016; 10(1): 67. CrossRef
Hepatoprotective Effects of Soybean Embryo by Enhancing Adiponectin-Mediated AMP-Activated Protein KinaseαPathway in High-Fat and High-Cholesterol Diet-Induced Nonalcoholic Fatty Liver Disease
Jihye Hong, Sera Kim, Hyun-Sook Kim
Journal of Medicinal Food.2016; 19(6): 549. CrossRef
The Relationship between Factors of Metabolic Syndrome in Korean Adult Males and the Parents' Family History of Diabetes
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The Journal of the Korea institute of electronic communication sciences.2013; 8(5): 779. CrossRef

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