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辛伐他汀不会影响维生素 D 状态,但低维生素 D 水平与血脂异常有关:一项随机对照试验的结果。

Simvastatin does not affect vitamin d status, but low vitamin d levels are associated with dyslipidemia: results from a randomised, controlled trial.

机构信息

Department of Endocrinology and Metabolism C, Aarhus Sygehus, Aarhus University Hospital, 8000 Aarhus, Denmark.

出版信息

Int J Endocrinol. 2010;2010:957174. doi: 10.1155/2010/957174. Epub 2009 Jul 21.

Abstract

Objectives. Statin drugs act as inhibitors of the 3-hydroxy-3methylglutaryl coenzyme A (HMG-CoA) reductase enzyme early in the mevalonate pathway, thereby reducing the endogenous cholesterol synthesis. In recent studies, it has been suggested from epidemiological data that statins also may improve vitamin D status, as measured by increased plasma 25-hydroxyvitamin D (25OHD) levels. We now report the results from a randomised controlled trial on effects of simvastatin on plasma 25OHD levels. Design and Methods. We randomised 82 healthy postmenopausal women to one year of treatment with either simvastatin 40 mg/d or placebo and performed measurement at baseline and after 26 and 52 weeks of treatment. The study was completed by 77 subjects. Results. Compared with placebo, plasma levels of cholesterol and low-density lipoproteins decreased in response to treatment with simvastatin, but our study showed no effect of simvastatin on vitamin D status. However, plasma levels of triglycerides were inversely associated with tertiles of plasma 25OHD levels and changes in plasma triglycerides levels correlated inversely with seasonal changes in vitamin D status. Conclusion. Our data do not support a pharmacological effect of statins on vitamin D status, but do suggest that vitamin D may influence plasma lipid profile and thus be of importance to cardiovascular health.

摘要

目的。他汀类药物作为 3-羟基-3-甲基戊二酰辅酶 A(HMG-CoA)还原酶的抑制剂,作用于甲羟戊酸途径的早期,从而减少内源性胆固醇的合成。最近的研究表明,从流行病学数据来看,他汀类药物也可能通过增加血浆 25-羟维生素 D(25OHD)水平来改善维生素 D 状况。我们现在报告一项关于辛伐他汀对血浆 25OHD 水平影响的随机对照试验结果。

设计和方法。我们将 82 名健康绝经后妇女随机分为辛伐他汀 40mg/d 或安慰剂组,治疗 1 年,并在基线和治疗 26 周和 52 周时进行测量。该研究由 77 名受试者完成。

结果。与安慰剂相比,辛伐他汀治疗可降低胆固醇和低密度脂蛋白水平,但我们的研究表明辛伐他汀对维生素 D 状态没有影响。然而,血浆甘油三酯水平与血浆 25OHD 水平的三分位数呈负相关,血浆甘油三酯水平的变化与维生素 D 状态的季节性变化呈负相关。

结论。我们的数据不支持他汀类药物对维生素 D 状态的药理作用,但确实表明维生素 D 可能影响血浆脂质谱,因此对心血管健康很重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/540c/2778175/7f7bbd6c28b6/IJE2010-957174.001.jpg

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