Department of Medical Research, Holstebro Hospital, Laegårdvej 12, DK-7500 Holstebro, Denmark.
J Clin Pharmacol. 2010 Jul;50(7):816-22. doi: 10.1177/0091270009350627. Epub 2010 Jan 7.
Statins improve cardiovascular survival in both nondiabetic and diabetic patients, but diabetic patients benefit more, in both primary and secondary prevention. Statins seem to have multiple effects beyond cholesterol lowering, that is, pleiotropic effects that may include changes in renal function. This study tests the hypothesis that acute treatment with atorvastatin may change glomerular filtration rate, tubular function, vasoactive hormones, blood pressure, and pulse rate in patients with type 2 diabetes. In an acute, randomized, placebo-controlled, double-blinded, crossover trial, the effects of atorvastatin on renal function, vasoactive hormones, blood pressure, and pulse rate are measured in 21 patients with type 2 diabetes. Patients are randomized to either 2 doses of atorvastatin 80 mg or placebo before 2 different study days. Treatment with atorvastatin induces a significant reduction in fractional sodium excretion compared with placebo, and sodium clearance tends to be reduced. No significant differences in glomerular filtration rate, albumin/creatinine ratio, vasoactive hormones, and blood pressure by acute treatment with atorvastatin are found in diabetic patients. Acute treatment with atorvastatin reduces renal fractional sodium excretion in patients with type 2 diabetes. No changes are measured in glomerular filtration rate, albumin/creatinine ratio, vasoactive hormones, and blood pressure.
他汀类药物可改善非糖尿病和糖尿病患者的心血管生存状况，但在一级和二级预防中，糖尿病患者获益更多。他汀类药物除了降低胆固醇外，似乎还有多种作用，即多效性作用，可能包括肾功能的变化。本研究检验了这样一个假设，即阿托伐他汀的急性治疗可能会改变 2 型糖尿病患者的肾小球滤过率、肾小管功能、血管活性激素、血压和脉搏率。在一项急性、随机、安慰剂对照、双盲、交叉试验中，21 例 2 型糖尿病患者的肾功能、血管活性激素、血压和脉搏率均接受阿托伐他汀治疗。患者随机分为阿托伐他汀 80mg 或安慰剂 2 个剂量，在 2 个不同的研究日进行治疗。与安慰剂相比，阿托伐他汀治疗可显著降低钠排泄分数，且钠清除率趋于降低。在糖尿病患者中，阿托伐他汀的急性治疗并未发现肾小球滤过率、白蛋白/肌酐比值、血管活性激素和血压有显著差异。阿托伐他汀的急性治疗可降低 2 型糖尿病患者的肾钠排泄分数，但肾小球滤过率、白蛋白/肌酐比值、血管活性激素和血压均无变化。
