Paulsen L, Holst L M, Bech J N, Starklint J, Pedersen E B
Department of Medical Research and Department of Medicine, Holstebro Hospital and Aarhus University, Holstebro, Denmark.
Scand J Clin Lab Invest. 2009;69(3):323-9. doi: 10.1080/00365510802571007.
Improved cardiovascular survival during statin treatment might be due to effects in addition to cholesterol lowering. We hypothesize that sodium intake affects renal function and vasoactive hormones in atorvastatin-treated healthy subjects.
In a randomized, placebo-controlled, double-blind, crossover study we measured the effect of a moderate change in sodium intake on glomerular filtration rate (GFR), blood pressure (BP), renal tubular function, plasma concentrations of vasoactive hormones and urinary excretion of aquaporin-2 (u-AQP2) in 22 healthy subjects. The subjects were randomized to standardized fluid intake and diet corresponding to the need for calories in the 4 days before each of the 2 examination days. In one of the periods they were randomized to receive sodium chloride tablets (2 g) thrice daily for 4 days. Two doses of atorvastatin (80 mg) were given; one at 2200 h the evening before the study day, the other at 0830 h in the morning.
24-h urinary sodium excretion increased by 23%. GFR and BP were unchanged. Sodium clearance, fractional excretion of sodium and u-AQP2 increased, whereas free water clearance decreased during high sodium intake. PRC and aldosterone were suppressed during the high sodium diet.
A change in dietary sodium intake of approximately 100 mmol daily does not change GFR and BP in atorvastatin-treated healthy men. The lack of change in BP might reflect that the subjects studied were not sodium sensitive, or that atorvastatin treatment modified sodium sensitivity.
他汀类药物治疗期间心血管疾病生存率的提高可能归因于除降低胆固醇之外的其他作用。我们推测钠摄入会影响阿托伐他汀治疗的健康受试者的肾功能和血管活性激素。
在一项随机、安慰剂对照、双盲、交叉研究中，我们测量了22名健康受试者钠摄入量适度变化对肾小球滤过率（GFR）、血压（BP）、肾小管功能、血管活性激素血浆浓度和水通道蛋白-2尿排泄量（u-AQP2）的影响。在两个检查日之前的4天里，受试者被随机分配至标准化液体摄入量和符合热量需求的饮食。在其中一个时间段，他们被随机分配接受每日三次的氯化钠片（2克），持续4天。给予两剂阿托伐他汀（80毫克）；一剂在研究日前一晚22:00服用，另一剂在次日上午08:30服用。
24小时尿钠排泄量增加了23%。GFR和BP未发生变化。高钠摄入期间，钠清除率、钠分数排泄和u-AQP2增加，而自由水清除率降低。高钠饮食期间，PRC和醛固酮受到抑制。
在阿托伐他汀治疗的健康男性中，每日饮食中钠摄入量约100 mmol的变化不会改变GFR和BP。BP未发生变化可能反映出所研究的受试者对钠不敏感，或者阿托伐他汀治疗改变了钠敏感性。
