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Efectos combinados de ezetimiba y fitosteroles en el metabolismo del colesterol: un estudio aleatorizado y controlado
Xiaobo Lin1, Susan B Racette, Michael Lefevre
1Division of Endocrinology, Metabolism, and Lipid Research, Department of Medicine, Washington University School of Medicine, St. Louis, MO 63110, USA.
Circulation
|July 20, 2011
Resumen
La adición de fitosteroles a la ezetimiba mejora significativamente el metabolismo del colesterol y reduce el colesterol LDL. Esta terapia combinada es prometedora para el tratamiento de la hipercolesterolemia.
Área de la Ciencia:
- Investigación Cardiovascular Investigación Cardiovascular Investigación Cardiovascular Investigación Cardiovascular Investigación Cardiovascular
- Ciencias de la Nutrición Ciencias de la Nutrición
- Farmacología Farmacología.
Sus antecedentes:
- Se sabe que la ezetimiba y los fitosteroles inhiben la absorción del colesterol.
- Este estudio investigó los efectos sinérgicos de la combinación de ezetimiba y fitosteroles.
Objetivo del estudio:
- Para probar la hipótesis de que la ezetimiba combinada con fitosteroles es más efectiva que la ezetimiba sola para alterar el metabolismo del colesterol.
- Para evaluar el impacto en la absorción de colesterol intestinal, la excreción de colesterol fecal y los niveles de colesterol LDL.
Principales métodos:
- Un estudio aleatorizado, doble ciego, controlado con placebo y triple cruce que involucró a 21 sujetos con hipercolesterolemia leve.
- Los sujetos recibieron una dieta controlada con ezetimibe placebo + phytosterol placebo, ezetimibe + phytosterol placebo o ezetimibe + phytosterols durante 3 semanas cada uno.
- Todas las comidas fueron proporcionadas por una cocina metabólica para asegurar el control de la dieta.
Principales resultados:
- La combinación de ezetimiba y fitosteroles redujo significativamente la absorción de colesterol intestinal en comparación con el control y la ezetimiba sola (P<0.0001).
- La excreción de colesterol fecal se incrementó significativamente con el tratamiento combinado (P<0.0001).
- Los niveles plasmáticos de colesterol lipoproteico de baja densidad se redujeron significativamente con ezetimibe + fitosteroles en comparación con el control (101 mg/dL frente a 129 mg/dL; P<0.0001).
Conclusiones:
- La adición de fitosteroles a la ezetimiba mejoró significativamente sus efectos sobre el metabolismo del colesterol y la reducción del colesterol LDL.
- La intervención combinada dietética y farmacológica pone de relieve el potencial de los fitosteroles como terapia adyuvante para la hipercolesterolemia.
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