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比较瑞舒伐他汀和阿托伐他汀对非糖尿病血脂异常患者糖代谢和脂联素水平的影响:一项前瞻性随机开放标签研究。

Comparative effects of rosuvastatin and atorvastatin on glucose metabolism and adipokine levels in non-diabetic patients with dyslipidaemia: a prospective randomised open-label study.

机构信息

Endocrinology Clinic, Hippokration Hospital, Thessaloniki, Greece.

出版信息

Int J Clin Pract. 2011 Jun;65(6):679-83. doi: 10.1111/j.1742-1241.2011.02655.x.

DOI:10.1111/j.1742-1241.2011.02655.x
PMID:21564441
Abstract

AIMS

The impact of statins on glucose metabolism and adipokines remains controversial. We compared the effects of rosuvastatin and atorvastatin on glucose homeostasis, insulin sensitivity (IS), adiponectin and leptin levels as well as systemic inflammation in non-diabetic patients with dyslipidaemia.

METHODS

Thirty-six patients were randomly assigned to 10 mg/day of rosuvastatin (n = 18) or 20 mg/day of atorvastatin (n = 18) for 12 weeks. Total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), non-HDL-C, triglycerides (TG), fasting plasma glucose, insulin, homeostasis model assessment-insulin resistance (HOMA-IR), quantitative IS check index (QUICKI), adiponectin, leptin and high-sensitivity C-reactive protein (hsCRP) were measured at baseline and after 4 and 12 weeks.

RESULTS

Both statins significantly lowered TC, LDL-C, non-HDL-C and TG compared with baseline. Only rosuvastatin caused a significant reduction in insulin and HOMA-IR levels (-35%, p = 0.005 and -33%, p = 0.011 respectively) and a significant increase in QUICKI (+11%, p = 0.003) at 12 weeks. In terms of adipokines and hsCRP, no difference was observed after 4 and 12 weeks of treatment with either statin.

CONCLUSIONS

Rosuvastatin compared with atorvastatin resulted in significant improvements in IS indices. No significant changes in adiponectin, leptin or hsCRP levels were observed at 4 and 12 weeks of treatment with either statin.

摘要

目的

他汀类药物对糖代谢和脂肪因子的影响仍存在争议。我们比较了瑞舒伐他汀和阿托伐他汀对非糖尿病血脂异常患者葡萄糖稳态、胰岛素敏感性(IS)、脂联素和瘦素水平以及全身炎症的影响。

方法

36 名患者被随机分为瑞舒伐他汀 10mg/天(n=18)或阿托伐他汀 20mg/天(n=18)组,治疗 12 周。在基线时和治疗 4 周和 12 周时测定总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、非高密度脂蛋白胆固醇(non-HDL-C)、甘油三酯(TG)、空腹血糖、胰岛素、稳态模型评估胰岛素抵抗(HOMA-IR)、定量胰岛素敏感指数(QUICKI)、脂联素、瘦素和高敏 C 反应蛋白(hsCRP)。

结果

两种他汀类药物均能显著降低 TC、LDL-C、non-HDL-C 和 TG 与基线相比。只有瑞舒伐他汀在 12 周时显著降低了胰岛素和 HOMA-IR 水平(-35%,p=0.005 和-33%,p=0.011),并显著增加了 QUICKI(+11%,p=0.003)。在脂联素和 hsCRP 方面,两种他汀类药物治疗 4 周和 12 周后均无差异。

结论

与阿托伐他汀相比,瑞舒伐他汀可显著改善 IS 指数。在治疗 4 周和 12 周时,两种他汀类药物均未观察到脂联素、瘦素或 hsCRP 水平的显著变化。

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