Relationships between metabolic syndrome and other baseline factors and the efficacy of ezetimibe/simvastatin and atorvastatin in patients with type 2 diabetes and hypercholesterolemia

Diabetes Care. 2010 May;33(5):1021-4. doi: 10.2337/dc09-1762. Epub 2010 Feb 11.

Abstract

Objective: To investigate relationships between baseline factors and treatment-associated efficacy changes in type 2 diabetes.

Research design: AND METHODS Multivariable analyses of treatment response in 1,229 type 2 diabetic patients with hypercholesterolemia who received ezetimibe/simvastatin or atorvastatin in a randomized double-blind 6-week study.

Results: Increasing age was related to improvements in all lipid assessments. Men had greater triglyceride and non-HDL cholesterol reductions than women, and black/Hispanic patients had less favorable lipid effects than other races/ethnicities. Increasing baseline LDL cholesterol was associated with improvements in most lipids; higher baseline non-HDL cholesterol with improved HDL cholesterol and triglycerides; higher baseline HDL cholesterol with greater non-HDL cholesterol and high-sensitivity C-reactive protein (hs-CRP) reductions; and higher baseline hs-CRP with smaller LDL cholesterol, non-HDL cholesterol, and apolipoprotein B reductions. Patients with high baseline non-HDL cholesterol or triglycerides less frequently attained LDL cholesterol targets. Obesity was inversely related to HDL cholesterol and hs-CRP changes, and higher baseline A1C to smaller apolipoprotein B reductions. Metabolic syndrome was not a significant predictor.

Conclusions: Treatment responses in type 2 diabetic patients were related to baseline factors, although treatment effects (ezetimibe/simvastatin being more effective than atorvastatin) remained consistent. The presence of predictive factors should be considered in planning lipid-altering therapy.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Anticholesteremic Agents / administration & dosage
  • Atorvastatin
  • Azetidines / administration & dosage*
  • Black People / statistics & numerical data
  • C-Reactive Protein / metabolism
  • Diabetes Mellitus, Type 2 / drug therapy*
  • Diabetes Mellitus, Type 2 / ethnology
  • Drug Combinations
  • Ezetimibe, Simvastatin Drug Combination
  • Female
  • Heptanoic Acids / administration & dosage*
  • Hispanic or Latino / statistics & numerical data
  • Humans
  • Hypercholesterolemia / drug therapy*
  • Hypercholesterolemia / ethnology
  • Male
  • Metabolic Syndrome / drug therapy*
  • Metabolic Syndrome / ethnology
  • Multivariate Analysis
  • Predictive Value of Tests
  • Pyrroles / administration & dosage*
  • Risk Factors
  • Simvastatin / administration & dosage*

Substances

  • Anticholesteremic Agents
  • Azetidines
  • Drug Combinations
  • Ezetimibe, Simvastatin Drug Combination
  • Heptanoic Acids
  • Pyrroles
  • C-Reactive Protein
  • Atorvastatin
  • Simvastatin