Abstract
We administered simvastatin (5mg/day for 6 months), an inhibitor of 3-hydroxy-3-methylglutaryl coenzyme A (HMG CoA) reductase (the cholesterol synthesis rate-limiting enzyme), to 28 patients with non insulin dependent diabetes mellitus complicated by hypercholesterolemia (serum cholesterol≥220mg/dl) and assessed its effect on remnant-like particles (RLP). Both RLP cholesterol (RLP) C) and LDL cholesterol (LDL-C) levels were decreased significantly by simvastatin. Intype lIb hyperlipidemia, changes in both RLP C and RLP-triglycerides (RLP-TG) were strongly correlated with changes in the serum TG level, but not with changes in LDL-C. In patients with type IIa hyperlipidemia, changes in RLP TG were strongly correlated with changes in TG, but the changes in RLP C were better correlated with changes in LDL-C than TG. Based on these findings, simvastatin reduces RLP in diabetes and appears to be potentially useful in preventing the progression of arteriosclerosis. Our findings also suggest that an RLP metabolic pathway other than LDL receptors is involved in type Ilb hyperlipidemia.
