Ezetimibe improves postprandial hyperlipemia and its induced endothelial dysfunction

Abstract Objective Postprandial hyperlipemia has been shown to impair endothelial function and contribute to the development of atherosclerosis. We investigated the association between postprandial lipid profiles and endothelial function, and we examined the effects of ezetimibe on postprandial hyperlipemia and lipemia-induced endothelial dysfunction. Methods A randomized prospective trial in which 10 mg/day of ezetimibe was administered to 10 subjects for 4 weeks and not administered to 10 subjects (control group) was performed. Lipid profiles and endothelial function, assessed by brachial artery flow-mediated dilation (FMD) during a fasting state and at 2, 4, 6 and 8 h after an oral cookie loading test, were determined before and after treatment for 4 weeks. Results In all subjects before treatment, the maximum reduction in postprandial %FMD was significantly correlated with the maximum increases in postprandial triglyceride (TG) ( r = −0.499, P < 0.05) and apolipoprotein B-48 (apoB-48) concentrations ( r = −0.551, P < 0.05). Ezetimibe treatment for 4 weeks significantly suppressed postprandial elevation in TG (area under the incremental curve, from 1419 ± 594 to 968 ± 321 mg h/dl, P < 0.05), remnant lipoprotein cholesterol (from 66.9 ± 27.6 to 38.9 ± 15.4 mg h/dl, P < 0.01) and apoB-48 (from 58.8 ± 27.5 to 36.2 ± 17.0 μg h/ml, P < 0.05) concentrations, and postprandial endothelial dysfunction assessed by %FMD (maximum reduction in %FMD, from −2.6 ± 1.1% to −1.2 ± 0.8%, P < 0.05), whereas no significant changes were observed in the control group. Conclusion Postprandial hyperlipemia is closely correlated with transient endothelial dysfunction. Ezetimibe improves postprandial hyperlipemia and its induced endothelial dysfunction.