糖尿病腎症に伴う脂質異常の制御は心血管イベントや腎症悪化の防止のために必須である。今回，アトルバスタチン（A）5mgで治療中の高コレステロール血症を伴う2型糖尿病腎症患者34名を無作為にA増量群（A10mgに増量）とエゼチミブ（E）併用群（E10mgを追加）に割り付け，前値と強化後3ヵ月の空腹時値を比較した。結果，non HDL-CとLDL-Cの変化率はE併用群で有意に大であった。腎や他のマーカーには有意な変化は認めなかった。本研究にて，用量依存的な腎保護作用が報告されているAの増量に比し，E併用がnon HDL-CとLDL-Cの変化率で優越性があり，安全性において同等であることを証明した。

   Controlling dyslipidemia is important to prevent cardiovascular events and the worsening of renal function in type 2 diabetic nephropathy with hyper-cholesterolemia(DNC). The present study aimed to compare the effects and safety of atorvastatin plus ezetimibe with atorvastatin in DNC. Patients were randomly allocated to group A (increased atorvastatin) or group E (added ezetimibe). The primary endpoint was the change in levels of non-HDL-C at 3 months after treatment intensification. Seventeen patients in each group completed the study. Non-HDL-C and LDL-C decreased in both groups, but the rate of change was significantly greater in group E and no difference in other parameters. Previous studies show that atorvastatin reduces urinary protein and improves kidney function in a dose-dependent manner in patients with CKD. In the present study, addition of ezetimibe showed superiority in the change of non HDL-C and LDL-C and showed equivalence in safety compared with increased atorvastatin in DNC.