SLIM: Combined Effects of Slo-Niacin and Atorvastatin on Lipoproteins and Inflammatory Markers in Hyperlipidemia
SLIM: Combined Effects of Slo-Niacin and Atorvastatin on Lipoproteins and Inflammatory Markers in Hyperlipidemia
Slo-Niacin and atorvastatin (Lipitor) are both drugs that lower cholesterol. In this
 research, we will compare the effectiveness of Slo-Niacin and atorvastatin taken alone and
 together. This study will help show how the individual benefits of the two drugs taken
 separately can be combined when taken together.
Combined niacin and a statin treatment has greater potential value than either agent alone
 for the dyslipidemia of insulin resistance, obesity and the metabolic syndrome. The efficacy
 of Slo-Niacin and atorvastatin has not been formally examined in this setting.

 Methods: Forty-four dyslipidemic men and women (LDL-C >130mg/dL and below average HDL-C (<55
 in women and <45 in men) were randomized to a 3 month course of atorvastatin 10 mg or
 Slo-Niacin increased monthly at doses of 500, 1000 and 1500 mg/day. The alternate drug was
 added in the second 3-month segment. Lipid profiles and transaminase measurements were
 obtained monthly and full lipoprotein quantifications, apoproteins, remnant like lipoproteins
 (RLP), LDL buoyancy, glucose, insulin, and C-reactive protein were measured at the end of
 each 3-month sequence. Results: Mean entry lipids were (mg/dL) TG 187, LDL-C 171, HDL-C 39.
 Mean BMI was 32.6 Kg/M2. When Slo-Niacin and atorvastatin were given alone, respective
 decreases in triglyceride (TG) were 18% and 10%, LDL-C 12% and 36% and non-HDL-C 15% and 36%.
 HDL-C increased 8% and 6%, respectively. Combined therapy decreased median TG 33% and mean
 LDL-C 43% and increased mean HDL-C 10%. Mean hs CRP decreased 23% and RLP 44.5% in the
 combined groups. Conclusions: Slo-Niacin with atorvastatin improves all lipoprotein
 fractions, RLP and hsCRP in combined hyperlipidemia. The reduction of LDL with the drug
 combination is equivalent to that obtained with 20-80 mg of atorvastatin alone.
Inclusion Criteria:

 -  LDL-C > 130 mg/dL

 -  HDL-C <= 45 mg/dL in men and <= 55 mg/dL in women

 Exclusion Criteria:

 -  history of hypersensitivity to any statin, niacin or aspirin

 -  diagnosis of diabetes or a fasting glucose > 125 mg/dL

 -  hyper or hypothyroidism (unless treatment stable)

 -  meet other health, medication, and logistical criteria