Pitavastatin prevents postprandial endothelial dysfunction via reduction of the serum triglyceride level in obese male subjects

Abstract

Obesity is a well-established risk factor for the development and progression of coronary heart disease. Moreover, endothelial dysfunction is an early event in atherosclerosis and is known to be associated with postprandial hypertriglyceridemia. The purpose of this study was to determine whether a statin might have an effect on postprandial hypertriglyceridemia, and thereby on endothelial function in obese subjects. Twenty-four obese male subjects were recruited for this study. They were randomly assigned to receive pitavastatin (2 mg/day) or placebo for 2 weeks. The oral fat loading test using OFTT cream was performed pre- and post-treatment, in which the lipid profile and flow-mediated dilation (FMD) were assessed before and 4 h after an oral fat load. In the oral fat loading test conducted pretreatment, the oral fat load induced a marked increase of the serum triglyceride (TG) level and decrease in FMD in the pitavastatin and placebo group. In the test conducted post-treatment, the increase in postprandial TG was attenuated (+183 vs. +81 mg/dL, P < 0.001) and decrease in postprandial FMD was completely abolished (-1.1 vs. +0.1%, P < 0.01) by pitavastatin treatment. Moreover, there was a good correlation between the change in postprandial TG and the change in postprandial FMD after the 2 weeks of treatment (r = -0.737, P < 0.001). Pitavastatin might prevent endothelial dysfunction caused by postprandial hypertriglyceridemia within 2 weeks of therapy in obese subjects.

An Increase in the EPA/AA Ratio is Associated with Improved Arterial Stiffness in Obese Patients with Dyslipidemia

“…The Japan Diabetes Complications Study also revealed that, in type 2 diabetic patients, the serum TG, as well as LDL-C, levels were leading predictors of coronary heart disease 44) . For more than two decades, studies have reported a positive relationship between the TG level and atherosclerotic indicators, such as the baPWV [45][46][47] , IMT 48) , forearm blood flow measured with plethysmography 49) , wall thickness measured with echocardiography 50) and flow-mediated dilation (FMD) 51) . In addition, an observational study reported that a decrease in the TG level due to pharmacological therapy was associated with improvement of the baPWV 45) and FMD 51) .…”

Postprandial lipemia as a cardiometabolic risk factor

“…Statins are effective in correcting postprandial endothelial dysfunction in obese and T2D patients [148][149][150] . Whether the beneficial effects of statins are related to a decreased production or to an increased catabolism of lipoproteins is debated.…”

Postprandial dysmetabolism: Too early or too late?

“…156 In addition, it has been shown that pitavastatin 2mg/ day may result in reduction of both postprandial hypertriglyceridemia and endothelial dysfunction in obese subjects and in patients with stable coronary artery heart disease. 157,158 Simvastatin 80mg has also been seen to be effective in reducing postprandial plasma triglyceride levels and triglyceride-content in lipoprotein fractions in male obese patients with metabolic syndrome. 159 …”