Aims: There has been no evidence on the effects of evolocumab, protein convertase subtilisin/kexin type 9 (PCSK9) inhibitor, on small size LDL. We observationally investigated the efficacy and side effects of evolocum...Aims: There has been no evidence on the effects of evolocumab, protein convertase subtilisin/kexin type 9 (PCSK9) inhibitor, on small size LDL. We observationally investigated the efficacy and side effects of evolocumab on the LDL subfraction particle diameter using PAGE system for lipoprotein analysis. Methods: We defined 30 patients with high-risk hyperlipidemia. As for analysis of LDL subfraction profile, we used polyacrylamide gel electrophoresis three methods: 1) 3% nondenatured poly-acrylamide gel electrophoresis method (3%PAGE), 2) 2% - 16% nondenatured poly-acrylamide gradient gel electro-phoresis method (2% - 16% GGE) and 3) 2.7% - 5% GGE. Evolocumab 140 mg/day administered together with statin significantly improved serum total cholesterol (TC), triglyceride (TG), high-dense lipoprotein-cholesterol (HDL-C), and LDL-C after four-week treatment. Results: TC, TG, HDL-C and LDL-C levels were improved by, respectively, 33%, 20%, 10%, and 54%. The mean LDL size significantly increased from 25.6 ± 0.4 nm to 26.4 ± 0.8 nm. The small dense LDL-cholesterol (sdLDL-C), large buoyant LDL-cholesterol (lbLDL-C), and mid-band lipoprotein-cholesterol were reduced, respectively. Therefore, the preliminary study on this paper can be the first step into a new insight on the world of lipid metabolism. Conclusion: Short-term administration of evolocumab addedons to statin therapy, significantly reduced small size LDL levels.展开更多
Introduction: It was recently reported that candesartan, an angiotensin II receptor blocker, had a protective effect against cardiovascular events, comparable to that of calcium channel antagonists. Moreover, a renopr...Introduction: It was recently reported that candesartan, an angiotensin II receptor blocker, had a protective effect against cardiovascular events, comparable to that of calcium channel antagonists. Moreover, a renoprotective effect and anti-diabetic action of candesartan had also been demonstrated. However, whether the renoprotective effect of candesartan, especially in diabetes, was dose-dependent or not remain to be fully elucidated. The present study attempted to clarify the dose effect of renoprotection by candesartan in Japanese type 2 diabetic patients. Subjects and Method: In this case series study, we recruited 26 type 2 diabetic patients with albuminuria whose blood pressure did not reach the target BP level (<130/80 mmHg) despite administration of 4 or 8 mg/day of candesartan. Subsequently, these lower doses of candesartan were increased to the maximal dose in Japan, 12 mg/day. Clinical parameters were examined before, at 6 and 12 months after the increase in dose. Results: An ameliorating effect of the increased dose of candesartan on albuminuria and hypertension was distinctly observed. No severe adverse effect was observed. Conclusion: It was highly possible that the maximal dose of candesartan provided more effective renoprotection in hypertensive type 2 diabetic patients initially treated with lower doses of candesartan.展开更多
文摘Aims: There has been no evidence on the effects of evolocumab, protein convertase subtilisin/kexin type 9 (PCSK9) inhibitor, on small size LDL. We observationally investigated the efficacy and side effects of evolocumab on the LDL subfraction particle diameter using PAGE system for lipoprotein analysis. Methods: We defined 30 patients with high-risk hyperlipidemia. As for analysis of LDL subfraction profile, we used polyacrylamide gel electrophoresis three methods: 1) 3% nondenatured poly-acrylamide gel electrophoresis method (3%PAGE), 2) 2% - 16% nondenatured poly-acrylamide gradient gel electro-phoresis method (2% - 16% GGE) and 3) 2.7% - 5% GGE. Evolocumab 140 mg/day administered together with statin significantly improved serum total cholesterol (TC), triglyceride (TG), high-dense lipoprotein-cholesterol (HDL-C), and LDL-C after four-week treatment. Results: TC, TG, HDL-C and LDL-C levels were improved by, respectively, 33%, 20%, 10%, and 54%. The mean LDL size significantly increased from 25.6 ± 0.4 nm to 26.4 ± 0.8 nm. The small dense LDL-cholesterol (sdLDL-C), large buoyant LDL-cholesterol (lbLDL-C), and mid-band lipoprotein-cholesterol were reduced, respectively. Therefore, the preliminary study on this paper can be the first step into a new insight on the world of lipid metabolism. Conclusion: Short-term administration of evolocumab addedons to statin therapy, significantly reduced small size LDL levels.
文摘Introduction: It was recently reported that candesartan, an angiotensin II receptor blocker, had a protective effect against cardiovascular events, comparable to that of calcium channel antagonists. Moreover, a renoprotective effect and anti-diabetic action of candesartan had also been demonstrated. However, whether the renoprotective effect of candesartan, especially in diabetes, was dose-dependent or not remain to be fully elucidated. The present study attempted to clarify the dose effect of renoprotection by candesartan in Japanese type 2 diabetic patients. Subjects and Method: In this case series study, we recruited 26 type 2 diabetic patients with albuminuria whose blood pressure did not reach the target BP level (<130/80 mmHg) despite administration of 4 or 8 mg/day of candesartan. Subsequently, these lower doses of candesartan were increased to the maximal dose in Japan, 12 mg/day. Clinical parameters were examined before, at 6 and 12 months after the increase in dose. Results: An ameliorating effect of the increased dose of candesartan on albuminuria and hypertension was distinctly observed. No severe adverse effect was observed. Conclusion: It was highly possible that the maximal dose of candesartan provided more effective renoprotection in hypertensive type 2 diabetic patients initially treated with lower doses of candesartan.
