AIM:To assess the effect of different hypolipidemic treatment strategies on glycemic profile in mixed dyslipidemia patients.METHODS:This is a prespecified analysis of a prospective,randomized,open-label,blinded end po...AIM:To assess the effect of different hypolipidemic treatment strategies on glycemic profile in mixed dyslipidemia patients.METHODS:This is a prespecified analysis of a prospective,randomized,open-label,blinded end point(PROBE)study(ClinicalTrials.gov identifier:NCT01010516).Patients(n=100)with mixed dyslipidemia on a standard statin dose who had not achieved lipid targets were randomized to switch to the highest dose of rosuvastatin(40 mg/d)or to add-on-statin extended release nicotinic acid(ER-NA)/laropiprant(LRPT)or to addon-statin micronised fenofibrate for a total of 3 mo.Fasting plasma glucose(FPG),glycosylated hemoglobin(HbA1c),homeostasis model assessment of insulin resistance(HOMA-IR)index and lipid profile were evaluated at baseline and 3 mo after treatment intervention.RESULTS:FPG increased in add-on ER-NA/LRPT and rosuvastatin monotherapy groups by 9.7%and 4.4%,respectively(P<0.01 between the 2 groups and compared with baseline),while it did not significantly change in the add-on fenofibrate group.Similarly,HbA1c increased by 0.3%in add-on ER-NA/LRPT group and by 0.2%in the rosuvastatin monotherapy group(P<0.01 for all comparisons vs baseline and for the comparison between the 2 groups),while no significant change was reported in the add-on fenofibrate group.HOMA-IR increased by 65%in add-on ER-NA/LRPT and by 14%in rosuvastatin monotherapy group,while it decreased by 6%in the add-on fenofibrate group(P<0.01 vs baseline and for all comparisons among the groups).Non-HDL-C decreased in all groups(by 237%,247%and 7%in the rosuvastatin,ER-NA/LRPT and fenofibrate group,respectively,P<0.01 for all vs baseline and P<0.01 for all vs with fenofibrate group).CONCLUSION:Both addition of ER-NA/LRPT and switch to the highest dose of rosuvastatin deteriorated glycemic profile in patients with mixed dyslipidemia,while add-on fenofibrate seems to increase insulin sensitivity.展开更多
文摘AIM:To assess the effect of different hypolipidemic treatment strategies on glycemic profile in mixed dyslipidemia patients.METHODS:This is a prespecified analysis of a prospective,randomized,open-label,blinded end point(PROBE)study(ClinicalTrials.gov identifier:NCT01010516).Patients(n=100)with mixed dyslipidemia on a standard statin dose who had not achieved lipid targets were randomized to switch to the highest dose of rosuvastatin(40 mg/d)or to add-on-statin extended release nicotinic acid(ER-NA)/laropiprant(LRPT)or to addon-statin micronised fenofibrate for a total of 3 mo.Fasting plasma glucose(FPG),glycosylated hemoglobin(HbA1c),homeostasis model assessment of insulin resistance(HOMA-IR)index and lipid profile were evaluated at baseline and 3 mo after treatment intervention.RESULTS:FPG increased in add-on ER-NA/LRPT and rosuvastatin monotherapy groups by 9.7%and 4.4%,respectively(P<0.01 between the 2 groups and compared with baseline),while it did not significantly change in the add-on fenofibrate group.Similarly,HbA1c increased by 0.3%in add-on ER-NA/LRPT group and by 0.2%in the rosuvastatin monotherapy group(P<0.01 for all comparisons vs baseline and for the comparison between the 2 groups),while no significant change was reported in the add-on fenofibrate group.HOMA-IR increased by 65%in add-on ER-NA/LRPT and by 14%in rosuvastatin monotherapy group,while it decreased by 6%in the add-on fenofibrate group(P<0.01 vs baseline and for all comparisons among the groups).Non-HDL-C decreased in all groups(by 237%,247%and 7%in the rosuvastatin,ER-NA/LRPT and fenofibrate group,respectively,P<0.01 for all vs baseline and P<0.01 for all vs with fenofibrate group).CONCLUSION:Both addition of ER-NA/LRPT and switch to the highest dose of rosuvastatin deteriorated glycemic profile in patients with mixed dyslipidemia,while add-on fenofibrate seems to increase insulin sensitivity.
