阿托伐他汀对高胆固醇血症患者核磁共振定义的脂蛋白亚类及炎症标志物的影响。

Effects of atorvastatin on nuclear magnetic resonance-defined lipoprotein subclasses and inflammatory markers in patients with hypercholesterolemia.

作者信息

Ikewaki Katsunori, Terao Yoshio, Ozasa Hideki, Nakada Yoshinobu, Tohyama Jun-ichiro, Inoue Yae, Yoshimura Michihiro

机构信息

Division of Anti-Aging, Department of Internal Medicine, National Defense Medical College, Tokorozawa, Saitama, Japan.

出版信息

J Atheroscler Thromb. 2009 Mar;16(1):51-6. doi: 10.5551/jat.e563. Epub 2009 Mar 5.

DOI:10.5551/jat.e563

PMID:19261998

Abstract

AIM

Information about the effects of HMG-CoA reductase inhibitor (statin) treatment on lipoprotein subclasses has been severely limited. Nuclear magnetic resonance (NMR) spectrometry has emerged as a new methodology to quantify lipoprotein subclass concentrations. In the present study, we attempted to evaluate the hypolipidemic effects of atorvastatin utilizing this method.

METHODS

Twenty-six patients were administered with atorvastain 10 mg daily for 4 weeks. Lipoprotein subclasses were measured by nuclear magnetic resonance (NMR) spectroscopy. Inflammation markers, including C-reactive protein (CRP), interleukin-6 (IL-6), and monocyte chemotactic protein-1 (MCP-1), were also determined.

RESULTS

Additional to a marked reduction of LDL-C (-43%), atorvastatin treatment significantly decreased TG, RLP-C, apoC-II, apoC-III, and apoE by 27%, 49%, 25%, 15%, and 28%, respectively. NMR analysis revealed marked reductions of all LDL subclasses, resulting in a significant reduction of LDL particle number as well as an increase in LDL particle size. Further, some VLDL were decreased and HDL particle size was increased by atorvastatin. Among inflammation markers, MDA-LDL and IL-6 were marginally to significantly decreased.

CONCLUSION

In addition to a strong LDL-C lowering function, atorvastatin exerts beneficial effects on TG-rich lipoproteins and inflammation in hypercholesterolemic patients.

摘要

目的

关于HMG-CoA还原酶抑制剂（他汀类药物）治疗对脂蛋白亚类影响的信息一直非常有限。核磁共振（NMR）光谱法已成为一种量化脂蛋白亚类浓度的新方法。在本研究中，我们试图利用这种方法评估阿托伐他汀的降血脂作用。

方法

26例患者每天服用10mg阿托伐他汀，持续4周。通过核磁共振（NMR）光谱法测量脂蛋白亚类。还测定了炎症标志物，包括C反应蛋白（CRP）、白细胞介素-6（IL-6）和单核细胞趋化蛋白-1（MCP-1）。

结果

除显著降低低密度脂蛋白胆固醇（LDL-C）（-43%）外，阿托伐他汀治疗还使甘油三酯（TG）、残粒样脂蛋白胆固醇（RLP-C）、载脂蛋白C-II（apoC-II）、载脂蛋白C-III（apoC-III）和载脂蛋白E（apoE）分别显著降低27%、49%、25%、15%和28%。NMR分析显示所有低密度脂蛋白亚类均显著减少，导致低密度脂蛋白颗粒数量显著减少以及低密度脂蛋白颗粒大小增加。此外，阿托伐他汀使一些极低密度脂蛋白（VLDL）减少，高密度脂蛋白（HDL）颗粒大小增加。在炎症标志物中，氧化型低密度脂蛋白（MDA-LDL）和白细胞介素-6略有至显著降低。