Martínez-Abundis E, Barrera-Durán C, González-Ortiz M, Hernández-Salazar E

Idioma: Español
Referencias bibliográficas: 28
Paginas: 88-95
Archivo PDF: 100.80 Kb.

RESUMEN

Introducción: La dislipidemia mixta acelera la aterosclerosis y conduce a enfermedad cardiovascular y muerte. Las fibras no solubles, como la inulina, han mostrado tener efecto sobre la dislipidemia. Objetivo: Evaluar el efecto de la combinación de simvastatina más inulina en comparación con simvastatina más ezetimiba en la dislipidemia mixta. Material y métodos: Ensayo clínico, al azar, doble ciego, controlado con grupo paralelo. Incluyó 60 individuos con dislipidemia mixta, sin tratamiento farmacológico o falla a estatinas y a cambios en el estilo de vida. Intervención: simvastatina (20 mg), inulina de agave (7 g) y placebo de ezetimiba, o bien simvastatina (20 mg), ezetimiba (10 mg) y placebo de inulina de agave, diario por la noche, durante 12 semanas. Resultados: Ambos grupos disminuyeron el colesterol total (235 ± 29 vs. 182 ± 42 mg/ dl; p = 0.001; y 236 ± 31 vs.160 ± 48 mg/dl; p ‹ 0.001), el colesterol de las lipoproteínas de baja densidad (C-LDL) (141 ± 32 vs. 99 ± 34 mg/dl; p ‹ 0.001; y 149 ± 35 vs. 89 ± 43 mg/dl; p ‹ 0.001) y los triglicéridos (284 ± 117 vs. 214 ± 137 mg/dl; p = 0.027; y 241 ± 81 vs. 180 ± 68 mg/dl; p ‹ 0.001), respectivamente para simvastatina más inulina y simvastatina más ezetimiba. Conclusión: Simvastatina más inulina disminuyó colesterol total, el C-LDL y los triglicéridos al igual que simvastatina más ezetimiba.

REFERENCIAS (EN ESTE ARTÍCULO)

1. Grundy SM, Howard B, Smith JS, Eckel R, Redberg R, Bonow RO. AHA conference proceedings prevention conference VI: diabetes and cardiovascular disease executive summary. Circulation. 2002;105:2231-9.

2. Cottrel DA, Marshall BJ, Falko JM. Therapeutic approaches to dyslipidemia in diabetes mellitus and metabolic syndrome. Curr Opin Cardiol. 2003;18:301-8.

3. Stone N, Robinson J, Lichtenstein AH, et al. 2013 ACC/AHA guideline on the treatment of blood cholesterol to reduce atherosclerotic cardiovascular risk in adults. Circulation. 2014;129:S1-S45.

4. Ray KK, Cannon CP, Braunwald E. Recent trials of lipid lowering. Int J Clin Pract. 2007;61:1145-59.

5. Bruckert E. New advances in lipid-modifying therapies for reducing cardiovascular risk. Cardiology. 2002;97:59-66.

6. Kosoglu T, Statkevich P, Johnson-Levonas AO, Paolini, J, Bergman A, Alton KB. Ezetimibe: a review of its metabolism, pharmacokinetics and drug interactions. Clin Pharmacokinet. 2005;44:467-94.

7. Dujovne CA, Ettinger MP, McNeer JF, et al.; for the Ezetimibe Study Group. Efficacy and safety of a potent new selective cholesterol absorption inhibitor, ezetimibe, in patients with primary hypercholesterolemia. Am J Cardiol. 2002;90:1092-7.

8. Mauro VF, Tuckerman CE. Ezetimibe for management of hypercholesterolemia. Am Pharmacother. 2003;37:839-48.

9. Anderson JW, Hanna TJ. Impact of nondigestible carbohydrates on serum lipoproteins and risk for cardiovascular disease. J Nutr. 1999;129:1457S-66S.

10. Delzenne NM, Williams CM. Prebiotics and lipid metabolism. Curr Opin Lipidol. 2002;13:61-7.

11. Balcázar Muñoz BR, Martínez-Abundis E, González-Ortiz M. Efecto de la administración oral de inulina sobre el perfil de lípidos y la sensibilidad a la insulina en individuos con obesidad y dislipidemia. Rev Med Chile. 2003;131:597-604.

12. Delzenne NM, Kok NN. Biochemical basis of oligofructose-induced hypolipidemia in animal models. J Nutr. 1999;129:1467S-70S.

13. Davison MH, Maki KC. Effects of dietary inulin on serum lipids. J Nutr. 1999;129:1474S-77S.

14. Jeyaseelan L, Rao PS. Methods of determining sample sizes in clinical trials. Indian Pediatr. 1989;26:115-21.

15. Grundy SM, Cleeman JI, Bairey Merz NC, et al. Implications of recent clinical trials for the National Cholesterol Education Program Adult Treatment Panel III Guidelines. Circulation. 2004;110:227-39.

16. Stroes ES, Thompson PD, Corsini A, et al. Statin-associated muscle symptoms: impact on statin therapy — European Atherosclerosis Society Consensus Panel Statement on Assessment, Aetiology and Management. Eur Heart J. 2015;36:1012-22.

17. Davis HR, Veltri EP. Review. Zetia: inhibition of Niemman Pick C1 Like1 (NCP1L1) to reduce intestinal cholesterol absorption and treat hyperlipidemia. J Atheroscler Thromb. 2007;14:99-108.

18. Ara T, Tumur I, Pandor A, et al. Ezetimibe for the treatment of hypercholesterolaemia: a systematic review and economic evaluation. Health Technol Asses. 2008;12(21).

19. González-Ortiz M, Martínez-Abundis E, Kam-Ramos AM, Henández-Salazar E, Ramos-Zavala MG. Effect of ezetimibe on insulin sensitivity and lipid profile in obese and dyslipidaemic patients. Cardiovasc Drugs Ther. 2006;20:143-6.

20. Cannon CP, Blazing MA, Giugliano RP, et al. Ezetimibe added to statin therapy after acute coronary syndromes. N Engl J Med. 2015;372: 2387-97.

21. Becker JD, Gordon YR, Morris PB, et al. Simvastatin vs. therapeutic lifestyle changes and supplements: randomized primary prevention trial. Mayo Clin Proc. 2008;83:758-64.

22. Dehghan P, Gargari BP, Asgharijafarabadi M. Effects of high performance inulin supplementation on glycemic status and lipid profile in women with type 2 diabetes: a randomized, placebo-controlled clinical trial. Health Promotion Perspectives. 2013;3:55-63.

23. Williams CM. Effects of inulin on lipid parameters in humans. J Nutr. 1999;129:1471S-73S.

24. Jackson KG, Taylor GRJ, Clohessy AM, Williams CM. The effect of the daily intake of inulin on fasting lipid, insulin and glucose concentrations in middle-aged men and women. Br J Nutr. 1999;82:23-30.

25. Urías-Silvas JE, Cani Patrice D, Delmée E, Neyrinck A, López MG, Delzenne NM. Physiological effects of dietary fructans extracted from agave tequilana Gto. and dasylirion spp. BJN. 2008;99:254-61.

26. Anderson JW, Hanna TJ. Impact of nondigestible carbohydrates on serum lipoproteins and risk for cardiovascular disease. J Nutr. 1999;129:1457S-66S.

27. Thies F, McGarry JM, Yaqoob P, et al. Association of n-3 polyunsaturated fatty acids with stability of atherosclerotic plaques: a randomized controlled trial. Lancet. 2003;361:477-85.

28. Kelly G. Inulin-type prebiotics: a review. (Part 2). Altern Med Rev. 2009;14:36-55.