Lee Wen-Jane, Lee Wen-Lieng, Tang Yih-Jing, Liang Kae-Woei, Chien Yu-Hon, Tsou Shung Sheng, Sheu Wayne Huey-Herng
Department of Education and Research, Taichung Veterans General Hospital, Taichung, Taiwan, ROC.
Clin Chim Acta. 2008 Apr;390(1-2):49-55. doi: 10.1016/j.cca.2007.12.013. Epub 2007 Dec 23.
Statins may improve lipid profiles and inflammation-associated biomarkers, but the effect on insulin sensitivity is controversial. We investigated the effects of 2 doses of pravastatin (40 and 10 mg/day) on insulin sensitivity and serum inflammatory markers in nondiabetic hypercholesterolemic patients.
This was a randomized, parallel, comparative design study. A total of 40 nondiabetic subjects with elevated low-density lipoprotein (LDL) cholesterol were randomized to either the 40 mg pravastatin/day group (n=21) or the 10 mg pravastatin/day group (n=19) for 8 weeks. The fasting serum lipid profile, homeostasis model assessment (HOMA), glucose and insulin response of the two-hour glucose tolerance test (2 h-OGTT), and several inflammatory markers were determined.
Eight weeks of pravastatin treatment in both dose groups led to a significant reduction in serum LDL cholesterol, total cholesterol, triglycerides, and total cholesterol/ high-density lipoprotein (HDL) cholesterol ratios (all p< 0.01 in 40 mg group and all p<0.05 in 10 mg group), though the 40 mg group had greater effects. Although the fasting HOMA insulin resistance did not change significantly in either group, glucose and insulin areas under the curve of 2 h-OGTT were significantly decreased, suggesting improvement in insulin sensitivity post glucose challenge. Serum CD-40 ligand concentration was significantly reduced in the 40 mg pravastatin/day group and soluble P-selectin significantly reduced in both groups.
Pravastatin treatment, at 10 mg or 40 mg daily for 8 weeks, reduced serum lipids and some inflammatory markers in nondiabetic hypercholesterolemic subjects. Furthermore, insulin resistance was improved even in short-term treatment by pravastatin.
他汀类药物可能改善血脂水平和炎症相关生物标志物，但对胰岛素敏感性的影响存在争议。我们研究了两种剂量的普伐他汀（40毫克/天和10毫克/天）对非糖尿病高胆固醇血症患者胰岛素敏感性和血清炎症标志物的影响。
这是一项随机、平行、对照设计研究。总共40名低密度脂蛋白（LDL）胆固醇升高的非糖尿病受试者被随机分为普伐他汀40毫克/天组（n = 21）或普伐他汀10毫克/天组（n = 19），治疗8周。测定空腹血脂水平、稳态模型评估（HOMA）、两小时葡萄糖耐量试验（2 h-OGTT）的血糖和胰岛素反应以及几种炎症标志物。
两个剂量组的普伐他汀治疗8周后，血清LDL胆固醇、总胆固醇、甘油三酯和总胆固醇/高密度脂蛋白（HDL）胆固醇比值均显著降低（40毫克组所有指标p < 0.01，10毫克组所有指标p < 0.05），尽管40毫克组的效果更明显。虽然两组空腹HOMA胰岛素抵抗均无显著变化，但2 h-OGTT曲线下的血糖和胰岛素面积显著降低，提示葡萄糖激发后胰岛素敏感性有所改善。40毫克普伐他汀/天组的血清CD-40配体浓度显著降低，两组的可溶性P-选择素均显著降低。
每天服用10毫克或40毫克普伐他汀治疗8周，可降低非糖尿病高胆固醇血症患者的血脂水平和一些炎症标志物。此外，即使是短期服用普伐他汀治疗也能改善胰岛素抵抗。
