CONCLUSIONS The results suggested that ezetimibe add-on to statin therapy is associated with an enhanced TNF-α-lowering effect  compared with statin monotherapy .
AIMS Statins are known to influence the status of adipokines , which play a key role in the pathophysiology of cardiometabolic diseases .
As the effect of ezetimibe as an add-on to statin therapy on the impact of statins on plasma adipokines levels is currently unclear , the aim of the present study was to investigate this through a meta- analysis of controlled trials .
Lipid-lowering treatment and inflammatory mediators in diabetes and chronic kidney disease.
BACKGROUND Inflammation may contribute to the high cardiovascular risk in diabetes mellitus ( DM ) and chronic kidney disease ( CKD ) . Monocyte chemoattractant protein-1 ( MCP-1 ) facilitates the recruitment of monocytes into atherosclerotic lesions and is involved in diabetic nephropathy . Interferon gamma ( IFNγ ) is important in atherosclerosis and increases the synthesis of chemokines including MCP-1 . Lipid-lowering treatment ( LLT ) with statins may have anti-inflammatory effects , and ezetimibe cotreatment provides additional cholesterol lowering . METHODS After a placebo run-in period , the effects of simvastatin alone ( S ) or simvastatin + ezetimibe ( S+E ) were compared in a r and omized , double-blind , cross-over study on inflammatory parameters . Eighteen DM patients with estimated glomerular filtration rate ( eGFR ) 15 - 59 mL/min × 1·73 m(2 ) ( CKD stages 3 - 4 ) ( DM-CKD ) and 21 DM patients with eGFR > 75 mL/min ( DM only ) were included . RESULTS At baseline , monocyte chemoattractant protein 1 ( MCP-1 ) ( P = 0·03 ) , IFNγ ( P = 0·02 ) , tumour necrosis factor-α ( TNFα ) ( P < 0·01 ) and soluble vascular adhesion molecule ( sVCAM ) ( P = 0·001 ) levels were elevated in DM-CKD compared with DM-only patients . LLT with S and S+E reduced MCP-1 levels ( P < 0·01 by anova ) and IFNγ levels ( P < 0·01 ) in DM-CKD patients but not in DM-only patients . Reductions were most pronounced with the combination treatment . CONCLUSIONS DM patients with CKD stages 3 - 4 had increased inflammatory activity compared with DM patients with normal GFR . Lipid-lowering treatment decreased the levels of MCP-1 and IFNγ in DM patients with concomitant CKD , which may be beneficial with regard to the progression of both atherosclerosis and diabetic nephropathy
CONCLUSIONS The results suggested that ezetimibe add-on to statin therapy is associated with an enhanced TNF-α-lowering effect  compared with statin monotherapy .
AIMS Statins are known to influence the status of adipokines , which play a key role in the pathophysiology of cardiometabolic diseases .
As the effect of ezetimibe as an add-on to statin therapy on the impact of statins on plasma adipokines levels is currently unclear , the aim of the present study was to investigate this through a meta- analysis of controlled trials .