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AIM:To assess the effect of different hypolipidemic treatment strategies on glycemic profile in mixed dyslipidemia patients.METHODS:This is a prespecified analysis of a prospective,randomized,open-label,blinded end point(PROBE)study(ClinicalTrials.gov identifier:NCT01010516).Patients(n=100)with mixed dyslipidemia on a standard statin dose who had not achieved lipid targets were randomized to switch to the highest dose of rosuvastatin(40 mg/d)or to add-on-statin extended release nicotinic acid(ER-NA)/laropiprant(LRPT)or to addon-statin micronised fenofibrate for a total of 3 mo.Fasting plasma glucose(FPG),glycosylated hemoglobin(HbA1c),homeostasis model assessment of insulin resistance(HOMA-IR)index and lipid profile were evaluated at baseline and 3 mo after treatment intervention.RESULTS:FPG increased in add-on ER-NA/LRPT and rosuvastatin monotherapy groups by 9.7%and 4.4%,respectively(P<0.01 between the 2 groups and compared with baseline),while it did not significantly change in the add-on fenofibrate group.Similarly,HbA1c increased by 0.3%in add-on ER-NA/LRPT group and by 0.2%in the rosuvastatin monotherapy group(P<0.01 for all comparisons vs baseline and for the comparison between the 2 groups),while no significant change was reported in the add-on fenofibrate group.HOMA-IR increased by 65%in add-on ER-NA/LRPT and by 14%in rosuvastatin monotherapy group,while it decreased by 6%in the add-on fenofibrate group(P<0.01 vs baseline and for all comparisons among the groups).Non-HDL-C decreased in all groups(by 237%,247%and 7%in the rosuvastatin,ER-NA/LRPT and fenofibrate group,respectively,P<0.01 for all vs baseline and P<0.01 for all vs with fenofibrate group).CONCLUSION:Both addition of ER-NA/LRPT and switch to the highest dose of rosuvastatin deteriorated glycemic profile in patients with mixed dyslipidemia,while add-on fenofibrate seems to increase insulin sensitivity.
AIM: To assess the effect of different hypolipidemic treatment strategies on glycemic profile in mixed dyslipidemia patients. METHODS: This is a prespecified analysis of a prospective, randomized, open-label, blinded end point (PROBE) study (ClinicalTrials.gov identifier: NCT01010516 ) Patients (n = 100) with mixed dyslipidemia on a standard statin dose who had not achieved lipid targets were randomized to switch to the highest dose of rosuvastatin (40 mg / d) or to add-on-statin extended release nicotinic acid ER-NA) / laropiprant (LRPT) or to addon-statin micronised fenofibrate for a total of 3 mo. Fasting plasma glucose (FPG), glycosylated hemoglobin (HbA1c), homeostasis model assessment of insulin resistance (HOMA- IR) index and lipid profiles were evaluated at baseline and 3 months after treatment intervention .RESULTS: FPG increased in add-on ER-NA / LRPT and rosuvastatin monotherapy groups by 9.7% and 4.4%, respectively (P <0.01 between the 2 groups and compared with baseline) while it did not significantly change in the add-on fenofibrate group. Similarly, HbA1c increased by 0.3% in add-on ER-NA / LRPT group and by 0.2% in the rosuvastatin monotherapy group (P <0.01 for all comparisons vs baseline and for the comparison between the 2 groups) while no significant change was reported in the add-on fenofibrate group. HOMA-IR increased by 65% in add-on ER-NA / LRPT and by 14% in rosuvastatin monotherapy group, while it decreased by 6% in the add- on fenofibrate group (P <0.01 vs baseline and for all comparisons among the groups) .Non-HDL-C decreased in all groups (by 237%, 247% and 7% in the rosuvastatin, ER-NA / LRPT and fenofibrate group, respectively, P <0.01 for all vs baseline and P <0.01 for all vs with fenofibrate group) .CONCLUSION: Both addition of ER-NA / LRPT and switch to the highest dose of rosuvastatin deteriorated glycemic profile in patients with mixed dyslipidemia, while add -on fenofibrate seems to increase insulin sensitivity.