Mallon Patrick W G, Miller John, Kovacic Jason C, Kent-Hughes Julia, Norris Richard, Samaras Katherine, Feneley Michael P, Cooper David A, Carr Andrew
National Centre in HIV Epidemiology and Clinical Research, University of New South Wales, 376 Victoria Street, Darlinghurst, Sydney, NSW 2010, Australia.
AIDS. 2006 Apr 24;20(7):1003-10. doi: 10.1097/01.aids.0000222072.37749.5a.
To determine the effect of the 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitor, pravastatin, on markers of cardiovascular risk and lipodystrophy in HIV-infected, protease inhibitor (PI)-treated men with hypercholesterolaemia.
A randomized, placebo-controlled, 16-week study was carried out on 33 HIV-infected, hypercholesterolaemic men (fasting total cholesterol > 6.5 mmol/L) on PI-containing therapy. Patients commenced dietary assessment and advice at week 0 and were randomized to 12 weeks pravastatin (40 mg each night) or placebo from week 4. The primary endpoint was the time-weighted change (TWAUC) in total cholesterol from week 0. Secondary endpoints included TWAUC cholesterol from week 4 (start of pravastatin), total and regional body fat, fasting lipids, glucose, insulin, and markers of cardiovascular risk.
Of 33 men randomized (pravastatin n = 16, mean age 48 years), 31 completed the study. Groups were matched for baseline cholesterol and body composition. Although there was no significant between-group difference in TWAUC cholesterol from week 0 (pravastatin -0.6 +/- 1.0 versus placebo -0.4 +/- 1.0 mmol/L/week; P = 0.8), TWAUC cholesterol from week 4 decreased more in the pravastatin group (-0.8 +/- 1.0 versus -0.3 +/- 0.9 mmol/L/week; P = 0.04). Neither triglycerides nor dietary intake changed. Subcutaneous fat increased significantly with pravastatin (+0.72 +/- 1.55 versus +0.19 +/- 0.48 kg change in limb fat, P < 0.04; +5.2 +/- 8.7 versus -1.3 +/- 13.7 cm change in abdominal subcutaneous fat, P = 0.02). Apart from homocystine, which decreased in the pravastatin group, there were no significant differences in other cardiovascular, lipid or glucose parameters.
Despite limited effects on cholesterol, 12 weeks use of pravastatin 40 mg each night in HIV-infected men with hypercholesterolaemia resulted in significant increases in subcutaneous fat.
确定3-羟基-3-甲基戊二酰辅酶A还原酶抑制剂普伐他汀对接受蛋白酶抑制剂（PI）治疗的高胆固醇血症HIV感染男性的心血管风险标志物和脂肪营养不良的影响。
对33例接受含PI治疗的HIV感染高胆固醇血症男性（空腹总胆固醇>6.5 mmol/L）进行了一项随机、安慰剂对照、为期16周的研究。患者在第0周开始进行饮食评估并接受建议，从第4周起随机分为普伐他汀组（每晚40 mg）或安慰剂组，为期12周。主要终点是从第0周起总胆固醇的时间加权变化（TWAUC）。次要终点包括从第4周（普伐他汀开始时）起的TWAUC胆固醇、全身和局部体脂、空腹血脂、血糖、胰岛素以及心血管风险标志物。
在随机分组的33名男性中（普伐他汀组n = 16，平均年龄48岁），31名完成了研究。两组在基线胆固醇和身体组成方面相匹配。尽管从第0周起两组间TWAUC胆固醇无显著差异（普伐他汀组为-0.6±1.0，安慰剂组为-0.4±1.0 mmol/L/周；P = 0.8），但普伐他汀组从第4周起TWAUC胆固醇下降更多（-0.8±1.0对比-0.3±0.9 mmol/L/周；P = 0.04）。甘油三酯和饮食摄入量均未改变。普伐他汀治疗后皮下脂肪显著增加（肢体脂肪变化为+0.72±1.55对比+0.19±0.48 kg，P < 0.04；腹部皮下脂肪变化为+5.2±8.7对比-1.3±13.7 cm，P = 0.02）。除普伐他汀组同型半胱氨酸降低外，其他心血管、血脂或血糖参数无显著差异。
尽管对胆固醇的影响有限，但每晚服用40 mg普伐他汀12周可使高胆固醇血症HIV感染男性的皮下脂肪显著增加。
