Chu Chih-Sheng, Lee Kun-Tai, Lee Ming-Yi, Su Ho-Ming, Voon Wen-Choi, Sheu Sheng-Hsiung, Lai Wen-Ter
Division of Cardiology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan, Republic of China.
Acta Cardiol. 2006 Jun;61(3):263-9. doi: 10.2143/AC.61.3.2014826.
Beyond lipid lowering, statins have pleiotropic effects with favourable benefits against atherogenesis. Withdrawal of statin therapy has been demonstrated to abrogate vascular protective activity and even increase the incidence of thrombotic vascular events. The purpose of this study is to investigate the serial changes of soluble CD40 ligand (sCD40L) and two adipocytokines, adiponectin and resistin, after short-term atorvastatin therapy and withdrawal in patients with hypercholesterolaemia.
Thirty-two patients with hypercholesterolaemia received atorvastatin 10 mg/day for 3 months. Serum lipid profiles, and levels of sCD40L, adiponectin and resistin, were assessed before and immediately after 3 months' statin therapy. Serum levels of sCD40L and adiponectin were also measured on the 3 consecutive days after statin withdrawal. After 3 months' statin therapy, levels of sCD40L (1.93 +/- 1.13 vs. 1.30 +/- 0.97 ng/mL), total cholesterol and low-density lipoprotein cholesterol (LDL-C) were all reduced significantly (p < 0.05). However, sCD40L level tended to increase towards baseline on the first and second days after statin withdrawal, but was not significantly elevated until the third day after withdrawal (1.89 +/- 1.28 vs. 1.30 +/- 0.97 ng/mL, p < 0.05). Total cholesterol and LDL-C levels did not increase during the 3 days of statin withdrawal. No significant changes of adiponectin and resistin levels were shown after statin therapy.
These results indicate that the effect of statin on sCD40L level was abrogated after therapy withdrawal, and was independent of serum cholesterol level. Statin therapy did not significantly alter levels of adiponectin and resistin.
除降脂作用外，他汀类药物具有多效性，对动脉粥样硬化形成有有益作用。已证明停用他汀类药物治疗会消除血管保护活性，甚至增加血栓性血管事件的发生率。本研究的目的是调查高胆固醇血症患者短期阿托伐他汀治疗及停药后可溶性CD40配体（sCD40L）以及两种脂肪细胞因子脂联素和抵抗素的系列变化。
32例高胆固醇血症患者接受10mg/天的阿托伐他汀治疗3个月。在他汀类药物治疗3个月前及治疗结束后即刻评估血脂谱以及sCD40L、脂联素和抵抗素水平。在他汀类药物停药后的连续3天也测量sCD40L和脂联素的血清水平。他汀类药物治疗3个月后，sCD40L水平（1.93±1.13对1.30±0.97ng/mL）、总胆固醇和低密度脂蛋白胆固醇（LDL-C）均显著降低（p<0.05）。然而，他汀类药物停药后的第1天和第2天，sCD40L水平趋于向基线升高，但直到停药后第3天才显著升高（1.89±1.28对1.30±0.97ng/mL，p<0.05）。他汀类药物停药的3天内总胆固醇和LDL-C水平未升高。他汀类药物治疗后脂联素和抵抗素水平无显著变化。
这些结果表明，停药后他汀类药物对sCD40L水平的作用消失，且与血清胆固醇水平无关。他汀类药物治疗未显著改变脂联素和抵抗素水平。
