Effects of non-statin antilipemic drugs on vascular endothelial function in patients with type 2 diabetes with hypercholesterolemia

Introduction Type 2 diabetes is a risk factor for atherosclerosis because concomitant hypercholesterolemia further exacerbates hyperglycemia. We compared the efficacy of non-statin and non-fibrate antilipemic drugs in type 2 diabetes patients with hypercholesterolemia, and evaluated the flow-mediated vasodilation (FMD), a marker of early atherosclerotic changes. Patients and methods Fifty outpatients (aged 39–79) with type 2 diabetes and low-density lipoprotein cholesterol levels of ≥120 mg/dl were randomly allocated into two groups: 23 patients first received ezetimibe for 4 months followed by eicosapentaenoic acid (EPA) for the next 4 months, and 27 patients first received eicosapentaenoic acid for 4 months followed by ezetimibe for the next 4 months. Glycated hemoglobin and serum lipid levels were measured before and 4 and 8 months after treatment. Ankle brachial pressure index, intimal medial thickness, and FMD were measured in 35 patients. A pretreatment group (group 0) was added. We compared data from groups 0, A (subjects receiving ezetimibe), and B (subjects receiving EPA) during and after treatment. Results Non-high-density lipoprotein cholesterol levels decreased significantly in group A compared with groups 0 and B. No significant difference in serum high-density lipoprotein cholesterol levels was observed among the groups, whereas triglyceride levels decreased significantly in group B compared with group 0. FMD increased significantly in groups A and B compared with group 0. Conclusion FMD investigation may affect the evaluation of early atherosclerotic changes, and the administration of ezetimibe and EPA may be useful for patients with type 2 diabetes with hypercholesterolemia because it improves vascular endothelial function.