Nagashima Hirotaka, Endo Masahiro
Department of Cardiology, Tokyo Heart Center, Osaki Hospital, Tokyo, Japan.
Heart Vessels. 2011 Jul;26(4):428-34. doi: 10.1007/s00380-010-0071-7. Epub 2010 Dec 4.
Obesity is a well-established risk factor for the development and progression of coronary heart disease. Moreover, endothelial dysfunction is an early event in atherosclerosis and is known to be associated with postprandial hypertriglyceridemia. The purpose of this study was to determine whether a statin might have an effect on postprandial hypertriglyceridemia, and thereby on endothelial function in obese subjects. Twenty-four obese male subjects were recruited for this study. They were randomly assigned to receive pitavastatin (2 mg/day) or placebo for 2 weeks. The oral fat loading test using OFTT cream was performed pre- and post-treatment, in which the lipid profile and flow-mediated dilation (FMD) were assessed before and 4 h after an oral fat load. In the oral fat loading test conducted pretreatment, the oral fat load induced a marked increase of the serum triglyceride (TG) level and decrease in FMD in the pitavastatin and placebo group. In the test conducted post-treatment, the increase in postprandial TG was attenuated (+183 vs. +81 mg/dL, P < 0.001) and decrease in postprandial FMD was completely abolished (-1.1 vs. +0.1%, P < 0.01) by pitavastatin treatment. Moreover, there was a good correlation between the change in postprandial TG and the change in postprandial FMD after the 2 weeks of treatment (r = -0.737, P < 0.001). Pitavastatin might prevent endothelial dysfunction caused by postprandial hypertriglyceridemia within 2 weeks of therapy in obese subjects.
肥胖是冠心病发生和发展的一个公认的危险因素。此外,内皮功能障碍是动脉粥样硬化的早期事件,已知与餐后高甘油三酯血症有关。本研究的目的是确定他汀类药物是否可能对餐后高甘油三酯血症有影响,从而对肥胖受试者的内皮功能产生影响。本研究招募了24名肥胖男性受试者。他们被随机分配接受匹伐他汀(2毫克/天)或安慰剂治疗2周。在治疗前后进行使用OFTT乳膏的口服脂肪负荷试验,在口服脂肪负荷前和4小时后评估血脂谱和血流介导的血管舒张(FMD)。在治疗前进行的口服脂肪负荷试验中,口服脂肪负荷导致匹伐他汀组和安慰剂组的血清甘油三酯(TG)水平显著升高,FMD降低。在治疗后进行的试验中,匹伐他汀治疗使餐后TG的升高得到缓解(+183对+81毫克/分升,P<0.001),餐后FMD的降低完全消除(-1.1对+0.1%,P<0.01)。此外,治疗2周后餐后TG的变化与餐后FMD的变化之间存在良好的相关性(r=-0.737,P<0.001)。匹伐他汀可能在肥胖受试者治疗的2周内预防餐后高甘油三酯血症引起的内皮功能障碍。