Arabul Mahmut, Gullulu Mustafa, Yilmaz Yusuf, Akdag Ibrahim, Kahvecioglu Serdar, Eren Mehmet Ali, Dilek Kamil
Department of Internal Medicine, Uludag University Medical School, Bursa 16059, Turkey.
Clin Biochem. 2008 Sep;41(13):1055-8. doi: 10.1016/j.clinbiochem.2008.05.010. Epub 2008 Jun 7.
Anemia, low-grade inflammation and/or alterations in lipid metabolism are common findings in individuals with end-stage renal disease (ESRD) despite advances in dialysis treatment. Hepcidin, a key regulator of iron metabolism, may play an important role in the interdependence of inflammation and anemia in ESRD patients. Statins may reduce cardiovascular events in dialysis patients and have pleiotropic effects in addition to lowering total and low-density lipoprotein (LDL)-cholesterol.
Because there is a paucity of data on the effect of statins on serum prohepcidin levels in dialysis patients, this 8-week study was conducted to test the effect of fluvastatin (80 mg/day, n=22) compared with placebo (n=18) on circulating serum prohepcidin, a prohormone of hepcidin, and high-sensitive C-reactive protein (hs-CRP) in dyslipidemic ESRD patients with renal anemia.
Fluvastatin treatment decreased total cholesterol (P<0.05), LDL-cholesterol (P<0.01), hs-CRP (P<0.05) and serum prohepcidin levels (P<0.05) significantly.
Our pilot data suggest that short-term statin treatment may exert a beneficial effect on serum prohepcidin levels in ESRD patients. The potential clinical benefits of statins on renal anemia need to be confirmed and expanded with an appropriately powered long-term study.
尽管透析治疗取得了进展，但贫血、低度炎症和/或脂质代谢改变在终末期肾病（ESRD）患者中仍很常见。铁调素是铁代谢的关键调节因子，可能在ESRD患者炎症与贫血的相互关系中起重要作用。他汀类药物可降低透析患者的心血管事件，除降低总胆固醇和低密度脂蛋白（LDL）胆固醇外，还具有多效性。
由于关于他汀类药物对透析患者血清前铁调素水平影响的数据较少，本为期8周的研究旨在测试氟伐他汀（80毫克/天，n = 22）与安慰剂（n = 18）相比，对伴有肾性贫血的血脂异常ESRD患者循环血清前铁调素（铁调素的前体激素）和高敏C反应蛋白（hs-CRP）的影响。
氟伐他汀治疗显著降低了总胆固醇（P < 0.05）、LDL胆固醇（P < 0.01）、hs-CRP（P < 0.05）和血清前铁调素水平（P < 0.05）。
我们的初步数据表明，短期他汀类药物治疗可能对ESRD患者的血清前铁调素水平产生有益影响。他汀类药物对肾性贫血的潜在临床益处需要通过适当规模的长期研究来证实和扩展。
