Division of Neurology, Nephrology and Rheumatology, Department of Internal Medicine, Nippon Medical School, Bunkyo-ku, Tokyo, Japan.
J Atheroscler Thromb. 2011;18(2):131-7. doi: 10.5551/jat.5553. Epub 2010 Nov 11.
It remains unclear whether the decrease in the ADMA level associated with statin treatment results from the LDL-C-lowering effect or the pleiotropic effects of statins. A prospective, controlled study was conducted to examine whether statin treatment affects serum ADMA concentrations in ischemic stroke patients.
Consecutive outpatients with non-cardiogenic ischemic stroke who had never been treated with statins and whose LDL-cholesterol level was higher than 140 mg/dL were enrolled and compared with control patients whose LDL-cholesterol level was lower than 140 mg/dL. Overall, 114 patients were enrolled in the study (56 and 58 in statin-treated and non-statin-treated groups, respectively). Patients in the statin group were treated with pravastatin 10 mg/day (n=15), fluvastatin 20 mg/day (n=14), pitavastatin 1 mg/day (n=14), or atorvastatin 10 mg/day (n=13).
The serum ADMA concentration and LDL-C level were significantly decreased by statin treatment (p=0.003 and p< 0.001, respectively), and the ADMA concentration in subjects treated with statins was significantly lower than that of the control (p=0.028). Multiple linear regression analysis showed that age (β=0.26, p< 0.05) and statin use (β=-0.20, p< 0.05) were independently associated with the ADMA level.
A significant relation between statin treatment and decreased levels of ADMA was demonstrated in ischemic stroke patients with an adequately controlled lipid profile, suggesting the statin treatment might prevent atherosclerotic disease in ischemic stroke patients through suppression of ADMA concentration.
尚不清楚与他汀类药物治疗相关的 ADMA 水平降低是源于 LDL-C 降低效应,还是他汀类药物的多效性效应。一项前瞻性、对照研究旨在观察他汀类药物治疗是否会影响缺血性脑卒中患者的血清 ADMA 浓度。
连续纳入从未接受过他汀类药物治疗且 LDL-胆固醇水平高于 140mg/dL 的非心源性缺血性脑卒中门诊患者,并与 LDL-胆固醇水平低于 140mg/dL 的对照患者进行比较。共有 114 例患者入组本研究(他汀类药物治疗组和非他汀类药物治疗组各 56 例和 58 例)。他汀类药物治疗组患者接受普伐他汀 10mg/天(n=15)、氟伐他汀 20mg/天(n=14)、匹伐他汀 1mg/天(n=14)或阿托伐他汀 10mg/天(n=13)治疗。
他汀类药物治疗显著降低了血清 ADMA 浓度和 LDL-C 水平(p=0.003 和 p<0.001),且他汀类药物治疗患者的 ADMA 浓度显著低于对照组(p=0.028)。多元线性回归分析显示,年龄(β=0.26,p<0.05)和他汀类药物使用(β=-0.20,p<0.05)与 ADMA 水平独立相关。
在血脂水平得到充分控制的缺血性脑卒中患者中,他汀类药物治疗与 ADMA 水平降低之间存在显著相关性,提示他汀类药物治疗可能通过抑制 ADMA 浓度来预防缺血性脑卒中患者的动脉粥样硬化性疾病。