Yuvaraj Srinivasan, Premkumar Vummidi Giridhar, Vijayasarathy Kothandaraman, Gangadaran Sitthu Govindaswamy Dinakaran, Sachdanandam Panchanatham
Department of Medical Biochemistry, University of Madras, Taramani Campus, Chennai - 600 113, Tamil Nadu, India.
Clin Biochem. 2007 Jun;40(9-10):623-8. doi: 10.1016/j.clinbiochem.2007.02.003. Epub 2007 Mar 19.
Tamoxifen (TAM), a non-steroidal anti-estrogen that is widely used in adjuvant therapy for all stages of breast carcinomas and in chemoprevention of high-risk group. The hepatic estrogenic effect of TAM induces hypertriglyceridemia by reduced activity of lipolytic enzymes (LPL) on triglycerides. Coenzyme Q10 (Co Q10), riboflavin and niacin are proved to be potent antioxidant and protective agents against many diseases including cancer and cardiovascular diseases (CVD). In this context, the objective of the study is to find the effect of the combined modality of Co Q10 (100 mg), riboflavin (10 mg) and niacin (50 mg) with TAM (10 mg twice a day) on serum lipids and lipoprotein levels in postmenopausal women with breast cancer.
The vitamin supplementation with tamoxifen was given for a period of 90 days. Blood samples were collected at the base line, 45th and 90th day during the course of treatment. Plasma total cholesterol (TC), free cholesterol (FC), ester cholesterol (EC), phospholipids (PL), triglycerides (TGL), free fatty acids (FFA), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C) and very low density cholesterol (VLDL-C) were estimated in 78 untreated, only TAM-treated and combinatorialy treated group along with 46 age- and sex-matched controls.
Serum TGL and VLDL-C (p<0.001) were found to be significantly elevated and LDL-C (p<0.01), significantly reduced among TAM-treated patients as compared to the untreated breast cancer subjects. All the lipids and lipoprotein levels were found to be significantly altered in the untreated breast cancer patients when compared to their normal counterparts. All the lipid and lipoprotein abnormalities were reverted back to near normal levels on 90 days of treatment on combinatorial therapy.
The study figures the altered lipid and lipoprotein levels in the untreated and TAM-treated breast cancer patients. On combination therapy with Co Q10, riboflavin and niacin, it counteracts the tamoxifen-induced hyperlipidemia to normal levels.
他莫昔芬（TAM）是一种非甾体类抗雌激素药物，广泛用于乳腺癌各阶段的辅助治疗以及高危人群的化学预防。TAM的肝脏雌激素样作用通过降低甘油三酯脂肪分解酶（LPL）的活性诱导高甘油三酯血症。辅酶Q10（Co Q10）、核黄素和烟酸被证明是有效的抗氧化剂和针对包括癌症和心血管疾病（CVD）在内的多种疾病的保护剂。在此背景下，本研究的目的是探究Co Q10（100毫克）、核黄素（10毫克）和烟酸（50毫克）与TAM（每日两次，每次10毫克）联合应用对绝经后乳腺癌妇女血脂和脂蛋白水平的影响。
给予他莫昔芬联合维生素补充剂治疗90天。在治疗过程中的基线、第45天和第90天采集血样。对78例未治疗、仅接受TAM治疗和联合治疗的患者以及46例年龄和性别匹配的对照者进行血浆总胆固醇（TC）、游离胆固醇（FC）、胆固醇酯（EC）、磷脂（PL）、甘油三酯（TGL）、游离脂肪酸（FFA）、高密度脂蛋白胆固醇（HDL-C）、低密度脂蛋白胆固醇（LDL-C）和极低密度脂蛋白胆固醇（VLDL-C）的测定。
与未治疗的乳腺癌患者相比，接受TAM治疗的患者血清TGL和VLDL-C显著升高（p<0.001），LDL-C显著降低（p<0.01）。与正常对照者相比，未治疗的乳腺癌患者所有血脂和脂蛋白水平均有显著改变。联合治疗90天后，所有脂质和脂蛋白异常均恢复至接近正常水平。
本研究表明未治疗和接受TAM治疗的乳腺癌患者脂质和脂蛋白水平发生改变。Co Q10、核黄素和烟酸联合治疗可将他莫昔芬诱导的高脂血症抵消至正常水平。
