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Exp Clin Endocrinol Diabetes 2002; 110(4): 182-187
DOI: 10.1055/s-2002-32150
Articles

© Johann Ambrosius Barth

Influence of simvastatin on LDL-subtypes in patients with heterozygous familial hypercholesterolemia and in patients with diabetes mellitus and mixed hyperlipoproteinemia[*]

H. C. Geiss, P. Schwandt, K. G. Parhofer
  • Department of Internal Medicine II, Klinikum Grosshadern, University of Munich, Germany
Further Information

Publication History

received 20 July 2001 first decision 21 November 2001

accepted 12 January 2002

Publication Date:
10 June 2002 (online)

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Summary

This study evaluates the influence of simvastatin on lipid concentrations and on LDL-subtype distribution in patients with heterozygous familial hypercholesterolemia and in patients with type 2 diabetes and mixed hyperlipoproteinemia.

Nine patients with familial hypercholesterolemia (LDL-cholesterol: 7.1 ± 1.1 mmol/L, triglycerides: 1.3 ± 0.4 mmol/L) and 8 patients with type 2 diabetes mellitus and mixed hyperlipoproteinemia (HbA1c 6.8 ± 1.1%, LDL-cholesterol: 4.8 ± 0.7 mmol/L, triglycerides: 2.5 ± 1.1 mmol/L) were examined. Cholesterol concentration was determined in 7 LDL-subfractions isolated by density gradient ultracentrifugation before and during simvastatin treatment (10-20 mg/d, 4 weeks).

Simvastatin decreased LDL-cholesterol (- 34%/- 30%, all p < 0.05) and triglycerides (- 2%, n.s./- 25%, p < 0.05), but had little effect on HDL-cholesterol (+ 7%/+ 2%, n.s.) in patients with familial hypercholesterolemia and diabetes mellitus, respectively. In both groups a significant reduction of cholesterol in each LDL-subfraction was observed. Large-buoyant (LDL-1, LDL-2) and intermediate-dense (LDL-3, LDL-4) LDL were reduced more than small-dense (LDL-5-LDL-7) LDL-subtypes (- 36%/- 38%/- 23%, respectively) in patients with familial hypercholesterolemia, while in diabetic patients cholesterol reduction was uniform in all LDL-subtypes (- 29%/- 27%/- 31%, respectively).

Simvastatin decreases cholesterol concentration in all LDL-subfractions in patients with familial hypercholesterolemia and in patients with diabetes mellitus with mixed hyperlipoproteinemia. However, the relative reduction of individual LDL-subtypes differed between both groups. This suggests that the effect of simvastatin on LDL-subtype distribution depends on the type of underlying hyperlipoproteinemia.

Key words:

Diabetes mellitus - Familial hypercholesterolemia - LDL-subfractions - LDL-subtypes - Simvastatin

1 This article was presented in part at the 12th international Symposium on Atherosclerosis (June 25-29, 2000, Stockholm, Sweden) and is published in abstract form in Atherosclerosis (Atheroscler 2000; 151: 37).

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1 This article was presented in part at the 12th international Symposium on Atherosclerosis (June 25-29, 2000, Stockholm, Sweden) and is published in abstract form in Atherosclerosis (Atheroscler 2000; 151: 37).

MD Klaus G. Parhofer

Department of Internal Medicine II

Klinikum Grosshadern

Marchioninistr. 15

81377 Munich

Germany

Phone: + 49-89-7095-3011

Fax: + 49-89-7095-8879

Email: parhofer@med2.med.uni-muenchen.de

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