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他汀类药物D研究:瑞舒伐他汀与氟伐他汀治疗对25羟维生素D水平影响的比较

STATIN-D study: comparison of the influences of rosuvastatin and fluvastatin treatment on the levels of 25 hydroxyvitamin D.

作者信息

Ertugrul Derun Taner, Yavuz Bunyamin, Cil Hicran, Ata Naim, Akin Kadir Okhan, Kucukazman Metin, Yalcin Ahmet Arif, Dal Kursad, Yavuz Burcu Balam, Tutal Emre

机构信息

Department of Internal Medicine, Kecioren Teaching and Research Hospital, Ankara, Turkey Department of Cardiology, Kecioren Teaching and Research Hospital, Ankara, Turkey Department of Biochemistry, Kecioren Teaching and Research Hospital, Ankara, Turkey Department of Internal Medicine, Hacettepe University Faculty of Medicine, Ankara, Turkey.

出版信息

Cardiovasc Ther. 2011 Apr;29(2):146-52. doi: 10.1111/j.1755-5922.2010.00141.x.

Abstract

Several studies have shown that low 25-hydroxyvitamin D levels are associated with higher risk of cardiovascular disease and an increase in 25-hydroxyvitamin D levels protects against cardiovascular disease. In this study, we aimed to compare the effects of rosuvastatin and fluvastatin on vitamin D metabolism. The study population consisted of 134 hyperlipidemic patients who had not previously been treated with lipid lowering medications. Patients were randomized in a 1:1 ratio to rosuvastatin 10 mg or fluvastatin 80 mg XL during the study. Lipid parameters, 25 hydroxyvitamin-D, and bone alkaline phosphatase (BALP) were obtained at baseline and after 8 weeks of rosuvastatin and fluvastatin treatment. Sixty-nine patients were administered rosuvastatin, and 65 patients fluvastatin. Total Cholesterol and LDL cholesterol decreased after 8 weeks of both rosuvastatin and fluvastatin treatments. Rosuvastatin was significantly more effective than fluvastatin on lowering total (P < 0.001) and LDL cholesterol (P < 0.001). There was a significant increase in 25-hydroxyvitamin D with rosuvastatin treatment (P < 0.001), whereas no significant change in 25-hydroxyvitamin D was observed with fluvastatin treatment. Mean BALP fell from 18.5 to 9.6 u/I (P < 0.001) with rosuvastatin and from 17.0 to 12.8 with fluvastatin (P= 0.004). There was no significant difference in BALP levels between rosuvastatin and fluvastatin treatment (P= 0.368). The present study demonstrated that 25-hydroxyvitamin D levels increased with rosuvastatin treatment; whereas fluvastatin treatment had no effect on 25-hydroxyvitamin D. This disparity could be related to the potency or the bioavailability of these two statins. Further studies are needed to clarify the relationship between statins and the vitamin D physiology.

摘要

多项研究表明,25-羟基维生素D水平较低与心血管疾病风险较高相关,而25-羟基维生素D水平升高可预防心血管疾病。在本研究中,我们旨在比较瑞舒伐他汀和氟伐他汀对维生素D代谢的影响。研究人群包括134名此前未接受过降脂药物治疗的高脂血症患者。在研究期间,患者按1:1的比例随机分为接受10mg瑞舒伐他汀或80mg XL氟伐他汀治疗。在基线以及瑞舒伐他汀和氟伐他汀治疗8周后,获取血脂参数、25-羟基维生素D和骨碱性磷酸酶(BALP)。69名患者接受瑞舒伐他汀治疗,65名患者接受氟伐他汀治疗。瑞舒伐他汀和氟伐他汀治疗8周后,总胆固醇和低密度脂蛋白胆固醇均下降。瑞舒伐他汀在降低总胆固醇(P<0.001)和低密度脂蛋白胆固醇(P<0.001)方面显著比氟伐他汀更有效。瑞舒伐他汀治疗后25-羟基维生素D显著升高(P<0.001),而氟伐他汀治疗后未观察到25-羟基维生素D有显著变化。瑞舒伐他汀治疗后平均BALP从18.5降至9.6 u/I(P<0.001),氟伐他汀治疗后从17.0降至12.8(P=0.004)。瑞舒伐他汀和氟伐他汀治疗之间的BALP水平无显著差异(P=0.368)。本研究表明,瑞舒伐他汀治疗可使25-羟基维生素D水平升高;而氟伐他汀治疗对25-羟基维生素D无影响。这种差异可能与这两种他汀类药物的效力或生物利用度有关。需要进一步研究来阐明他汀类药物与维生素D生理学之间的关系。

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