Arnaud Josiane, Akbaraly Tasnime N, Hininger-Favier Isabelle, Berr Claudine, Roussel Anne-Marie
INSERM, U884, F-38000 Grenoble, France.
J Trace Elem Med Biol. 2009;23(1):21-8. doi: 10.1016/j.jtemb.2008.08.001. Epub 2008 Oct 10.
This secondary analysis of "Etude du Vieillissement Artériel" (EVA) study reports the effect of fibrates and statins on plasma selenium concentration and its 9-year change in free-living dyslipidemic elderly. Dyslipidemic patients were categorized in three sub-groups according to final low-density lipoprotein (LDL)-cholesterol level or hypolipidemic treatment: non-treated dyslipidemic (LDL-cholesterol >4.41 mmol/L, n=84); dyslipidemics who were treated exclusively by fibrates (n=47) or by statins (n=25) whatever their serum LDL-cholesterol concentration. The influence of lipid-lowering treatments on plasma selenium concentrations and its 9-year change was evaluated by analysis of variance (ANOVA) and multivariate linear regression models taking into account cardiovascular risk and changes in lipid-profile parameters. Multivariate linear regression indicated that the plasma selenium decline was associated with the longitudinal variation in LDL (beta=-0.039+/-0.019, p=0.04) and high-density lipoprotein (HDL)-cholesterol concentrations (beta=0.187+/-0.059, p=0.002) but not with triglycerides (beta=-0.018+/-0.031, p=0.57). During the 9-year follow-up, similar plasma selenium declines were observed in all the sub-groups (p=0.33) despite plasma selenium levels being higher in fibrate users and lower in statin users (p=0.0004). The mechanisms underlying these data are not yet totally understood, but considering the risk of selenium deficiency in the elderly and its relationship with poor health status further clinical trial is needed to verify the proposed hypotheses.
这项对“动脉老化研究”（EVA）的二次分析报告了贝特类药物和他汀类药物对血脂异常的老年人血浆硒浓度及其9年变化的影响。血脂异常患者根据最终低密度脂蛋白（LDL）胆固醇水平或降脂治疗分为三个亚组：未治疗的血脂异常患者（LDL胆固醇>4.41 mmol/L，n = 84）；无论血清LDL胆固醇浓度如何，仅接受贝特类药物（n = 47）或他汀类药物（n = 25）治疗的血脂异常患者。通过方差分析（ANOVA）和多变量线性回归模型评估降脂治疗对血浆硒浓度及其9年变化的影响，同时考虑心血管风险和血脂谱参数的变化。多变量线性回归表明，血浆硒下降与LDL的纵向变化（β=-0.039±0.019，p = 0.04）和高密度脂蛋白（HDL）胆固醇浓度（β= 0.187±0.059，p = 0.002）有关，但与甘油三酯无关（β=-0.018±0.031，p = 0.57）。在9年的随访期间，尽管贝特类药物使用者的血浆硒水平较高，他汀类药物使用者的血浆硒水平较低（p = 0.0004），但所有亚组的血浆硒下降情况相似（p = 0.33）。这些数据背后的机制尚未完全了解，但考虑到老年人硒缺乏的风险及其与健康状况不佳的关系，需要进一步的临床试验来验证所提出的假设。
