Simvastatin 10 mg/day decreased triglyceride by 26% compared with 26.5% for atorvastatin 5 mg/day. Moreover, the triglyceride/LDL cholesterol ratio was fairly constant across all statins and doses for patients with baseline triglyceride levels of <150 mg/dL, 150–250 mg/dL, and >250 mg/dL, at 0.0 ± 0.3, 0.5 ± 0.2, and 1.2 ± 0.3, respectively. In subjects with combined hyperlipidemia treated with 10 mg simvastatin, triglyceride reduction similar to that reported for the 5 mg atorvastatin dose was seen. Although some of these TG may be de-esterified to glycerol and FA which can be oxidized, the rest will just be stored in the liver or again secreted in newly formed VLDLs. 2019 May 24;8(5):742. doi: 10.3390/jcm8050742. Fenofibrate therapy to lower serum triglyceride concentrations in persons with spinal cord injury: A preliminary analysis of its safety profile. Find NCBI SARS-CoV-2 literature, sequence, and clinical content: https://www.ncbi.nlm.nih.gov/sars-cov-2/. We conclude that all statins are effective in decreasing triglyceride levels, but only in hypertriglyceridemic patients. Triglycerides: Emerging Targets in Diabetes Care? Dosage adjustment may be needed based on renal function, race, or drug interactions. Sandesara PB, Virani SS, Fazio S, Shapiro MD. Triglycerides are a type of fat your body produces to store extra calories that you consume during the day. Statins They lower LDL and triglycerides and can slightly raise HDL. ScienceDirect ® is a registered trademark of Elsevier B.V. ScienceDirect ® is a registered trademark of Elsevier B.V. Get the latest research from NIH: https://www.nih.gov/coronavirus. Comparisons of effects of statins (atorvastatin, fluvastatin, lovastatin, pravastatin, and simvastatin) on fasting and postprandial lipoproteins in patients with coronary heart disease versus control subjects. Cholesterol-lowering drugs work best when combined with a low-cholesterol diet and an exercise program. In 1996, the first 2 studies using 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase inhibitor (“statin”) therapy in hypertriglyceridemic subjects were published. The Forgotten Lipids: Triglycerides, Remnant Cholesterol, and Atherosclerotic Cardiovascular Disease Risk. La Fountaine MF, Cirnigliaro CM, Hobson JC, Lombard AT, Specht AF, Dyson-Hudson TA, Bauman WA. Whereas a dose-dependent triglyceride response was apparent with increasing doses of atorvastatin, the triglyceride… We then assessed the effect of various statins on triglycerides using a pooled laboratory database of 2,689 subjects who had participated in 7 separate studies with similar designs. STATIN CONVERSION CHART % LDL Reduction Simvastatin (Zocor) Atorvastatin (Lipitor) Rosuvastatin (Crestor) Fluvastatin (Lescol) Lovastatin (Mevacor) Pravastatin (Pravachol) Ezetimibe/Simvastatin … Am J Cardiol. In subjects with isolated triglyceride elevations who were treated with atorvastatin 5, 20, and 80 mg/day, large and dose-related … There are other ways to lower TG. doi: 10.1016/s0002-9149(02)02229-4. Only the baseline triglyceride level was significantly (p <0.001) related to this ratio. We then assessed the effect of various statins on triglycerides using a pooled laboratory database of 2,689 subjects who had participated in 7 separate studies with similar designs. When you get your cholesterol levels tested, most doctors also test triglyceride levels, since high levels of these fats also increase your risk for heart disease. In 1996, the first 2 studies using 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase inhibitor ("statin") therapy in hypertriglyceridemic subjects were published. Due to the relatively constant triglyceride/LDL cholesterol ratio, our analysis indicates that the more effective the statin is in decreasing LDL cholesterol, the more effective it will also be in decreasing triglyceride levels in patients with hypertriglyceridemia. 2002 Mar 7;89(5A):50C-57C. High doses of a strong statin (simvastatin, atorvastatin, rosuvastatin) lower triglycerides, by as much as approximately 50%, and raise high-density lipoprotein (HDL) cholesterol. In subjects with combined hyperlipidemia treated with 10 mg simvastatin, triglyceride reduction similar to that reported for the 5 mg atorvastatin dose was seen. HHS The 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors (“statins”) have been in general clinical use for over a decade and in clinical trials for nearly 15 years.1, 2During this time the focus for their use has been directed at decreasing low-density lipoprotein (LDL) cholesterol. Schaefer EJ, McNamara JR, Tayler T, Daly JA, Gleason JL, Seman LJ, Ferrari A, Rubenstein JJ. Table I displays the triglyceride and LDL cholesterol reductions and triglyceride/LDL cholesterol ratio for the studies by Bakker-Arkema and coworkers and Stein et al. The triglyceride/LDL cholesterol ratio was evaluated using a linear model that included baseline triglyceride level, drug, and dose. Entry into these studies required a triglyceride level of <400 mg/dL. Please enable it to take advantage of the complete set of features! All of the studies had a placebo run-in followed by a randomized, double-blind, active treatment phase of at least 4 weeks with a statin. Alexopoulos AS, Qamar A, Hutchins K, Crowley MJ, Batch BC, Guyton JR. Curr Diab Rep. 2019 Feb 26;19(4):13. doi: 10.1007/s11892-019-1136-3. Moreover, the triglyceride/LDL cholesterol ratio was fairly constant across all statins and doses for patients with baseline triglyceride levels of <150 mg/dL, 150-250 mg/dL, and >250 mg/dL, at 0.0+/-0.3, 0.5+/-0.2, and 1.2+/-0.3, respectively. Copyright © 1998 Elsevier Science Inc. All rights reserved. 2004 Jan 1;93(1):31-9. doi: 10.1016/j.amjcard.2003.09.008. Comparison of Statins in Hypertriglyceridemia. To standardize these assessments, we devised a ratio that related changes in triglyceride levels to the known predictable response of low-density lipoprotein (LDL) cholesterol to statins. The triglyceride/LDL cholesterol ratio was evaluated using a linear model that included baseline triglyceride level, drug, and dose. All of the studies had a placebo run-in followed by a randomized, double-blind, active treatment phase of at least 4 weeks with a statin. Review of Moderate Hypertriglyceridemia in Diabetes. Efficacy and safety of a new HMG-CoA reductase inhibitor, atorvastatin, in patients with hypertriglyceridemia. 2003 Dec 11;145(50):46-9. In response to these findings, we conducted comparative assessments to determine whether all statins are effective in lowering triglyceride levels and whether their effect on triglycerides is related to factors such as drug, dose, and baseline triglyceride levels. 2019 Apr 1;40(2):537-557. doi: 10.1210/er.2018-00184. The triglyceride/LDL cholesterol ratio was initially applied to several published studies, and found to be approximately 1.0 and 0.5 in hypertriglyceridemic and nonhypertriglyceridemic populations, respectively. In response to these findings, we conducted comparative assessments to determine whether all statins are effective in lowering triglyceride levels and whether their effect on triglycerides is related to factors such as drug, dose, and baseline triglyceride levels. The Centers for Disease Control and Prevention lists cardiovascular-related diseases as a leading cause of mortality.1 The medication class of 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors, more commonly known as statins… Entry into these studies required a triglyceride level of <400 mg/dL. J Clin Med. Only the baseline triglyceride level was significantly (p <0.001) related to this ratio. NIH The remaining three recommendations build on this. National Center for Biotechnology Information, Unable to load your collection due to an error, Unable to load your delegates due to an error. Since statins lower TG by endocytosing TG-rich apoB particles, the TG themselves are simply re-compartmentalized by going from plasma into the liver. When baseline triglyceride was <150 mg/dL, no significant or dose-dependent effect on triglyceride was seen. Bakker-Arkema RG, Davidson MH, Goldstein RJ, Davignon J, Isaacsohn JL, Weiss SR, Keilson LM, Brown WV, Miller VT, Shurzinske LJ, Black DM. This site needs JavaScript to work properly. This triglyceride/LDL cholesterol ratio was obtained by dividing the percent change from baseline in the triglyceride level by the percent change from baseline in the LDL cholesterol level. https://doi.org/10.1016/S0002-9149(98)00041-1. When baseline triglyceride was <150 mg/dL, no significant or dose-dependent effect on triglyceride was seen. Effect of Lipid-Testing Interval on Stoke Risk among Newly Diagnosed Dyslipidemia Patients Initiated on Statins. J Spinal Cord Med. COVID-19 is an emerging, rapidly evolving situation. Cons: one of the least-studied statins, meaning there's less evidence that its cholesterol-lowering benefits translate into a lower risk … The lower the better? Due to the relatively constant triglyceride/LDL cholesterol ratio, our analysis indicates that the more effective the statin is in decreasing LDL cholesterol, the more effective it will also be in decreasing triglyceride levels in patients with hypertriglyceridemia.  |  Appendix A: Grouping of statins. We use cookies to help provide and enhance our service and tailor content and ads.