Galvano Fabio, Li Volti Giovanni, Malaguarnera Michele, Avitabile Teresio, Antic Tijana, Vacante Marco, Malaguarnera Mariano
University of Catania, Department of Biological Chemistry, Medical Chemistry and Molecular Biology, Viale A. Doria 6, 95125 Catania, Italy.
Expert Opin Pharmacother. 2009 Aug;10(12):1875-82. doi: 10.1517/14656560903081745.
The aim of the present study was to compare the effects of simvastatin and L-carnitine coadministration versus simvastatin monotherapy on lipid profile, lipoprotein(a) (Lp(a)) and apoprotein(a) (Apo(a)) levels in type II diabetic patients.
PATIENTS/METHODS: In this double-blind, randomized clinical trial, 75 patients were assigned to one of two treatment groups for 4 months. Group A received simvastatin monotherapy; group B received L-carnitine and simvastatin. The following variables were assessed at baseline, after washout and at 1, 2, 3 and 4 months of treatment: body mass index, fasting plasma glucose, glycated hemoglobin, total cholesterol, low-density lipoprotein (LDL) cholesterol, high-density lipoprotein (HDL) cholesterol, triglycerides, Apolipoprotein A1, Apo B, lipoprotein(a) and apoprotein(a).
At the end of treatment in the carnitine and simvastatin combined group compared with the simvastatin alone group, we observed a significant decrease in glycemia (p < 0.001), triglycerides (p < 0.001), Apo B (p < 0.05), Lp(a) (p < 0.05), apo(a) (p < 0.05), while HDL significantly increased (p < 0.05).
The coadministration of carnitine and simvastatin resulted in a significant reduction in Lp(a) and apo(a) and may represent a new therapeutic option in reducing plasma Lp(a) levels, LDL cholesterol and Apo B100.
本研究旨在比较辛伐他汀与左旋肉碱联合用药和辛伐他汀单药治疗对II型糖尿病患者血脂谱、脂蛋白(a)（Lp(a)）和载脂蛋白(a)（Apo(a)）水平的影响。
患者/方法：在这项双盲、随机临床试验中，75名患者被分配到两个治疗组之一，治疗4个月。A组接受辛伐他汀单药治疗；B组接受左旋肉碱和辛伐他汀治疗。在基线、洗脱期后以及治疗1、2、3和4个月时评估以下变量：体重指数、空腹血糖、糖化血红蛋白、总胆固醇、低密度脂蛋白（LDL）胆固醇、高密度脂蛋白（HDL）胆固醇、甘油三酯、载脂蛋白A1、载脂蛋白B、脂蛋白(a)和载脂蛋白(a)。
与辛伐他汀单药组相比，在肉碱和辛伐他汀联合治疗组治疗结束时，我们观察到血糖（p < 0.001）、甘油三酯（p < 0.001）、载脂蛋白B（p < 0.05）、Lp(a)（p < 0.05）、载脂蛋白(a)（p < 0.05）显著降低，而HDL显著升高（p < 0.05）。
肉碱和辛伐他汀联合用药可显著降低Lp(a)和载脂蛋白(a)，可能是降低血浆Lp(a)水平、LDL胆固醇和载脂蛋白B100的一种新的治疗选择。
