Effects of ezetimibe on hypercholesterolemia in the lipid profile in patients with metabolic syndrome: Zenith Trial

Abstract

BackgroundEzetimibe may be more effective in patients with high cholesterol absorption than in patients with low cholesterol absorption. This prospective study was performed to evaluate the effect of ezetimibe on hypercholesterolemia in patients with metabolic syndrome (MetS). Methods and results81 patients with hypercholesterolemia in the presence or absence of MetS (MetS or non-MetS group) initially received ezetimibe (10mg/day). In both groups, the levels of total cholesterol (TC), triglyceride, low-density lipoprotein cholesterol (LDL-C), non-high-density lipoprotein cholesterol (non-HDL-C) and the ratio of LDL-C to HDL-C (L/H) significantly decreased with treatment. A ratio of lathosterol to TC (lathosterol/TC) in the MetS group was significantly higher than that in the non-MetS group before treatment. Lathosterol/TC significantly increased after treatment in both groups, and campesterol/TC and sitosterol/TC significantly decreased. The non-MetS group, but not the MetS group, showed a significant increase in cholesterol/TC after treatment. Finally, we divided all of the patients into two groups (responders and non-responders) according to the percent changes in LDL-C after treatment. Male gender (p=0.037), the presence of MetS (p=0.026) and lower levels of L/H (p=0.006) were independent factors that predicted a response to ezetimibe. ConclusionsThe lipid-lowering effect of ezetimibe in MetS was comparable to that in non-MetS. Treatment with ezetimibe may be effective in males with MetS and relatively lower levels of L/H.