Fujita Hiroki, Koshimura Jun, Sato Takehiro, Miura Takeshi, Sasaki Hiroshi, Morii Tsukasa, Narita Takuma, Kakei Masafumi, Ito Seiki, Yamada Yuichiro
Division of Endocrinology, Metabolism and Geriatric Medicine, Department of Internal Medicine, Akita University School of Medicine, Akita, Japan.
Ren Fail. 2007;29(7):791-6. doi: 10.1080/08860220701543056.
To explore the renoprotective and anti-inflammatory effects of pravastatin, we analyzed the changes in renal function and urinary monocyte chemoattractant protein-1 (MCP-1) level as a renal tubulointerstitial inflammatory biomarker and serum MCP-1 level as a systemic inflammatory biomarker following the introduction of treatment with 10 mg/day of pravastatin in 10 hyperlipidemic type 2 diabetic patients with normoalbuminuria. Twelve months of the pravastatin treatment did not affect urinary levels of albumin, transferrin, N-acetylglucosaminidase, or MCP-1 in the hyperlipidemic diabetic patients, whereas the treatment significantly reduced serum levels of MCP-1 in the patients. The pravastatin treatment effectively lowered low-density lipoprotein cholesterol (LDL-C) levels in the hyperlipidemic diabetic patients to levels nearly to those in 11 non-hyperlipidemic type 2 diabetic patients with normoalbuminuria. Interestingly, serum MCP-1 levels were significantly lower in the hyperlipidemic patients treated with pravastatin than in the non-hyperlipidemic patients. No significant correlation was observed between serum LDL-C and MCP-1 levels in all the data in the hyperlipidemic patients before and after the pravastatin treatment and in the non-hyperlipidemic patients. These results collectively indicate that pravastatin may ameliorate systemic vascular inflammation rather than local renal inflammation in hyperlipidemic type 2 diabetic patients with normoalbuminuria, independent of its cholesterol-lowering effects.
为探究普伐他汀的肾脏保护和抗炎作用,我们分析了10例血脂异常的正常白蛋白尿2型糖尿病患者在开始每日服用10 mg普伐他汀治疗后,肾功能的变化以及作为肾小管间质炎症生物标志物的尿单核细胞趋化蛋白-1(MCP-1)水平和作为全身炎症生物标志物的血清MCP-1水平。普伐他汀治疗12个月对血脂异常糖尿病患者的尿白蛋白、转铁蛋白、N-乙酰氨基葡萄糖苷酶或MCP-1水平无影响,而该治疗显著降低了患者的血清MCP-1水平。普伐他汀治疗有效降低了血脂异常糖尿病患者的低密度脂蛋白胆固醇(LDL-C)水平,使其接近11例正常白蛋白尿的非血脂异常2型糖尿病患者的水平。有趣的是,接受普伐他汀治疗的血脂异常患者的血清MCP-1水平显著低于非血脂异常患者。在普伐他汀治疗前后的血脂异常患者以及非血脂异常患者的所有数据中,未观察到血清LDL-C与MCP-1水平之间存在显著相关性。这些结果共同表明,在正常白蛋白尿的血脂异常2型糖尿病患者中,普伐他汀可能改善全身血管炎症而非局部肾脏炎症,且独立于其降胆固醇作用。