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他汀类药物对冠心病患者血清 n-3 至 n-6 多不饱和脂肪酸比值的影响。

Effects of statins on serum n-3 to n-6 polyunsaturated fatty acid ratios in patients with coronary artery disease.

机构信息

Division of Cardiology, Department of Internal Medicine, Yokohama Sakae Kyosai Hospital, Yokohama, Japan.

出版信息

J Cardiovasc Pharmacol Ther. 2013 Jul;18(4):320-6. doi: 10.1177/1074248412473202. Epub 2013 Jan 15.

Abstract

BACKGROUND

A low n-3 to n-6 polyunsaturated fatty acids (PUFAs) ratio is reported to be associated with cardiovascular events. However, the effects of statins on this ratio have not been fully examined.

METHODS

A total of 101 patients with coronary artery disease, who were not receiving lipid-lowering therapy were randomly assigned to receive either 4 mg/day of pitavastatin or 20 mg/day of pravastatin. Serum PUFA levels were measured at baseline and 8 months after treatment with statins.

RESULTS

Pitavastatin was used to treat 51 patients and the remaining 50 patients were treated using pravastatin. A significant positive correlation was observed between the percent change in low-density lipoprotein cholesterol and that in dihomogamma-linolenic acid (r = .376, P = .007), arachidonic acid (AA; r = .316, P = .02), eicosapentaenoic acid (EPA; r = .408, P = .003), or docosahexaenoic acid (DHA; r = .270, P = .056) in the pitavastatin group. However, these correlations were not observed in the pravastatin group. The DHA/AA ratio decreased significantly in the pitavastatin group only (from 0.96 to 0.83, P = .0002) and the DHA/AA ratio was significantly lower in the pitavastatin group at 8 months (0.83 vs 0.96, P = .03). The EPA/AA ratio did not show significant changes in either group.

CONCLUSIONS

Pitavastatin decreased the serum DHA/AA ratio, whereas pravastatin had no effect on this ratio. Neither pitavastatin nor pravastatin had an effect on the serum EPA/AA ratio in patients with coronary artery disease.

摘要

背景

有报道称,n-3 与 n-6 多不饱和脂肪酸(PUFAs)的比值低与心血管事件有关。然而,他汀类药物对此比值的影响尚未得到充分研究。

方法

共纳入 101 例未接受降脂治疗的冠心病患者,随机分为每日 4 mg 匹伐他汀组和每日 20 mg 普伐他汀组。治疗 8 个月后检测血清 PUFAs 水平。

结果

51 例患者接受匹伐他汀治疗,50 例患者接受普伐他汀治疗。匹伐他汀组低密度脂蛋白胆固醇(LDL-C)的变化百分比与二高γ-亚麻酸(DHA;r =.376,P =.007)、花生四烯酸(AA;r =.316,P =.02)、二十碳五烯酸(EPA;r =.408,P =.003)和二十二碳六烯酸(DHA;r =.270,P =.056)的变化百分比呈显著正相关。然而,这些相关性在普伐他汀组并未观察到。只有匹伐他汀组的 DHA/AA 比值显著降低(从 0.96 降至 0.83,P =.0002),并且在 8 个月时匹伐他汀组的 DHA/AA 比值显著低于普伐他汀组(0.83 比 0.96,P =.03)。两组的 EPA/AA 比值均无显著变化。

结论

匹伐他汀降低了血清 DHA/AA 比值,而普伐他汀对此比值无影响。匹伐他汀和普伐他汀均未影响冠心病患者的血清 EPA/AA 比值。

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