他汀类药物与铁的关联：动脉疾病预防的抗炎干预。
The statin-iron nexus: anti-inflammatory intervention for arterial disease prevention.
机构信息
Research Service, Veterans Affairs Hospital, White River Junction, VT 05009, USA.
出版信息
Am J Public Health. 2013 Apr;103(4):e105-12. doi: 10.2105/AJPH.2012.301163. Epub 2013 Feb 14.
Abstract
OBJECTIVES
We postulated the existence of a statin-iron nexus by which statins improve cardiovascular disease outcomes at least partially by countering proinflammatory effects of excess iron stores.
METHODS
Using data from a clinical trial of iron (ferritin) reduction in advanced peripheral arterial disease, the Iron and Atherosclerosis Study, we compared effects of ferritin levels versus high-density lipoprotein to low-density lipoprotein ratios (both were randomization variables) on clinical outcomes in participants receiving and not receiving statins.
RESULTS
Statins increased high-density lipoprotein to low-density lipoprotein ratios and reduced ferritin levels by noninteracting mechanisms. Improved clinical outcomes were associated with lower ferritin levels but not with improved lipid status.
CONCLUSIONS
There are commonalities between the clinical benefits of statins and the maintenance of physiologic iron levels. Iron reduction may be a safe and low-cost alternative to statins.
摘要
目的
我们假设存在他汀类药物-铁的关联，通过抵消过量铁储存的促炎作用，他汀类药物至少部分改善了心血管疾病的预后。
方法
利用一项关于铁（铁蛋白）减少在晚期外周动脉疾病（铁和动脉粥样硬化研究）中的临床试验数据，我们比较了铁蛋白水平与高密度脂蛋白对低密度脂蛋白比值（两者都是随机变量）对接受和不接受他汀类药物治疗的参与者临床结局的影响。
结果
他汀类药物通过非交互机制增加了高密度脂蛋白对低密度脂蛋白的比值并降低了铁蛋白水平。改善的临床结果与较低的铁蛋白水平相关，而与改善的脂质状态无关。
结论
他汀类药物的临床益处与维持生理铁水平之间存在共同之处。减少铁可能是一种安全且低成本的替代他汀类药物的方法。
相似文献
1
The statin-iron nexus: anti-inflammatory intervention for arterial disease prevention.他汀类药物与铁的关联：动脉疾病预防的抗炎干预。
Am J Public Health. 2013 Apr;103(4):e105-12. doi: 10.2105/AJPH.2012.301163. Epub 2013 Feb 14.
2
Ferritin levels, inflammatory biomarkers, and mortality in peripheral arterial disease: a substudy of the Iron (Fe) and Atherosclerosis Study (FeAST) Trial.铁蛋白水平、炎症生物标志物与外周动脉疾病患者的死亡率：铁（Fe）与动脉粥样硬化研究（FeAST）试验的子研究。
J Vasc Surg. 2010 Jun;51(6):1498-503. doi: 10.1016/j.jvs.2009.12.068. Epub 2010 Mar 20.
3
Atherogenic Lipoprotein Subfractions Determined by Ion Mobility and First Cardiovascular Events After Random Allocation to High-Intensity Statin or Placebo: The Justification for the Use of Statins in Prevention: An Intervention Trial Evaluating Rosuvastatin (JUPITER) Trial.通过离子淌度测定的致动脉粥样硬化脂蛋白亚组分以及随机分配至高强度他汀类药物或安慰剂组后的首次心血管事件：他汀类药物用于预防的理由：一项评估瑞舒伐他汀的干预试验（JUPITER试验）
Circulation. 2015 Dec 8;132(23):2220-9. doi: 10.1161/CIRCULATIONAHA.115.016857. Epub 2015 Sep 25.
4
Statin effects on both low-density lipoproteins and high-density lipoproteins: is there a dual benefit?他汀类药物对低密度脂蛋白和高密度脂蛋白的影响：是否有双重获益？
Curr Atheroscler Rep. 2010 Jan;12(1):14-9. doi: 10.1007/s11883-009-0085-8.
5
On-treatment non-high-density lipoprotein cholesterol, apolipoprotein B, triglycerides, and lipid ratios in relation to residual vascular risk after treatment with potent statin therapy: JUPITER (justification for the use of statins in prevention: an intervention trial evaluating rosuvastatin).接受强效他汀类药物治疗后，治疗中检测的非高密度脂蛋白胆固醇、载脂蛋白 B、甘油三酯和血脂比值与残余血管风险的关系：JUPITER（他汀类药物预防作用的验证：一项评价瑞舒伐他汀的干预试验）。
J Am Coll Cardiol. 2012 Apr 24;59(17):1521-8. doi: 10.1016/j.jacc.2011.12.035.
6
Assessment of Trends in Statin Therapy for Secondary Prevention of Atherosclerotic Cardiovascular Disease in US Adults From 2007 to 2016.评估 2007 年至 2016 年美国成年人中他汀类药物用于动脉粥样硬化性心血管疾病二级预防的趋势。
JAMA Netw Open. 2020 Nov 2;3(11):e2025505. doi: 10.1001/jamanetworkopen.2020.25505.
7
Current status and future directions in lipid management: emphasizing low-density lipoproteins, high-density lipoproteins, and triglycerides as targets for therapy.血脂管理的现状与未来方向：强调将低密度脂蛋白、高密度脂蛋白和甘油三酯作为治疗靶点
Vasc Health Risk Manag. 2010 Mar 3;6:73-85. doi: 10.2147/vhrm.s8725.
8
Statins, high-density lipoprotein cholesterol, and regression of coronary atherosclerosis.他汀类药物、高密度脂蛋白胆固醇与冠状动脉粥样硬化的消退
JAMA. 2007 Feb 7;297(5):499-508. doi: 10.1001/jama.297.5.499.
9
A Critical Review of the Consensus Statement from the European Atherosclerosis Society Consensus Panel 2017.对 2017 年欧洲动脉粥样硬化学会共识小组共识声明的批判性评价。
Pharmacology. 2018;101(3-4):184-218. doi: 10.1159/000486374. Epub 2018 Jan 19.
10
Cholesterol Efflux Capacity, High-Density Lipoprotein Particle Number, and Incident Cardiovascular Events: An Analysis From the JUPITER Trial (Justification for the Use of Statins in Prevention: An Intervention Trial Evaluating Rosuvastatin).胆固醇流出能力、高密度脂蛋白颗粒数量与心血管事件发生率：来自JUPITER试验（他汀类药物在预防中的应用依据：一项评估瑞舒伐他汀的干预试验）的分析
Circulation. 2017 Jun 20;135(25):2494-2504. doi: 10.1161/CIRCULATIONAHA.116.025678. Epub 2017 Apr 27.
引用本文的文献
1
Understanding the causes and consequences of low statin adherence: evidence from UK Biobank primary care data.了解低他汀类药物依从性的原因及后果：来自英国生物银行初级保健数据的证据。
BMC Med. 2025 Jul 22;23(1):436. doi: 10.1186/s12916-025-04228-2.
2
The validity of serum ferritin levels in predicting cardiovascular events of metabolic dysfunction-associated steatotic liver disease patients may need more consideration.血清铁蛋白水平在预测代谢功能障碍相关脂肪性肝病患者心血管事件方面的有效性可能需要更多的考量。
Hepatobiliary Surg Nutr. 2024 Aug 1;13(4):755-756. doi: 10.21037/hbsn-24-217. Epub 2024 Jul 22.
3
Possible link between statin and iron deficiency anemia: A South Korean nationwide population-based cohort study.他汀类药物与缺铁性贫血之间的可能关联：一项韩国全国基于人群的队列研究。
Sci Adv. 2023 Oct 27;9(43):eadg6194. doi: 10.1126/sciadv.adg6194.
4
Prevalence of anemia and associated All-Cause mortality among adults with Diabetes: The role of chronic kidney disease.成年人糖尿病贫血的患病率及相关全因死亡率：慢性肾脏病的作用。
Diabetes Res Clin Pract. 2023 Jun;200:110695. doi: 10.1016/j.diabres.2023.110695. Epub 2023 May 6.
5
Ironing out macrophages in atherosclerosis.消除动脉粥样硬化中的巨噬细胞。
Acta Biochim Biophys Sin (Shanghai). 2023 Jan 25;55(1):1-10. doi: 10.3724/abbs.2022196.
6
The Effects of Statin Treatment on Serum Ferritin Levels: A Systematic Review and Meta-Analysis.他汀类药物治疗对血清铁蛋白水平的影响：一项系统评价和荟萃分析。
J Clin Med. 2022 Sep 5;11(17):5251. doi: 10.3390/jcm11175251.
7
Potential hazards of recent trends in liberal iron use for renal anemia.肾性贫血自由使用铁剂的近期趋势的潜在危害。
Clin Kidney J. 2020 Aug 21;14(1):59-69. doi: 10.1093/ckj/sfaa117. eCollection 2021 Jan.
8
Impact of trial design and patient heterogeneity on the identification of clinically effective therapies for progressive MS.临床试验设计和患者异质性对识别进展性多发性硬化症的临床有效疗法的影响。
Mult Scler. 2018 Dec;24(14):1795-1807. doi: 10.1177/1352458518800800. Epub 2018 Oct 10.
9
Iron, inflammation and atherosclerosis risk in men vs. perimenopausal women.男性与围绝经期女性的铁、炎症及动脉粥样硬化风险
Atherosclerosis. 2015 Jul;241(1):249-54. doi: 10.1016/j.atherosclerosis.2015.03.032. Epub 2015 Mar 20.
10
Attenuation of morphine analgesic tolerance by rosuvastatin in naïve and morphine tolerance rats.瑞舒伐他汀对吗啡镇痛耐受的影响：在未耐受和吗啡耐受大鼠中的研究。
Inflammation. 2015 Feb;38(1):134-41. doi: 10.1007/s10753-014-0015-y.
本文引用的文献
1
Might the beneficial effects of statin drugs be related to their action on iron metabolism?他汀类药物的有益作用是否与其对铁代谢的作用有关？
QJM. 2012 Dec;105(12):1225-9. doi: 10.1093/qjmed/hcs204. Epub 2012 Oct 24.
2
Body iron stores and risk of type 2 diabetes: results from the European Prospective Investigation into Cancer and Nutrition (EPIC)-Potsdam study.人体铁储存与 2 型糖尿病风险：来自欧洲癌症与营养前瞻性调查（EPIC）-波茨坦研究的结果。
Diabetologia. 2012 Oct;55(10):2613-2621. doi: 10.1007/s00125-012-2633-y. Epub 2012 Jul 1.
3
Hepcidin destabilizes atherosclerotic plaque via overactivating macrophages after erythrophagocytosis.肝铁调素通过红细胞吞噬后过度激活巨噬细胞使动脉粥样硬化斑块不稳定。
Arterioscler Thromb Vasc Biol. 2012 May;32(5):1158-66. doi: 10.1161/ATVBAHA.112.246108. Epub 2012 Mar 1.
4
Is universal pediatric lipid screening justified?对所有儿童进行血脂筛查是否合理？
JAMA. 2012 Jan 18;307(3):259-60. doi: 10.1001/jama.2011.2012.
5
Three reasons to abandon low-density lipoprotein targets: an open letter to the Adult Treatment Panel IV of the National Institutes of Health.放弃低密度脂蛋白目标的三个理由：致国立卫生研究院成人治疗小组IV的公开信
Circ Cardiovasc Qual Outcomes. 2012 Jan;5(1):2-5. doi: 10.1161/CIRCOUTCOMES.111.964676.
6
Statin use and risk of diabetes mellitus in postmenopausal women in the Women's Health Initiative.女性健康倡议中绝经后女性使用他汀类药物与患糖尿病风险的关系
Arch Intern Med. 2012 Jan 23;172(2):144-52. doi: 10.1001/archinternmed.2011.625. Epub 2012 Jan 9.
7
Long-term efficacy of upstream therapy with lipophilic or hydrophilic statins on antiarrhythmic drugs in patients with paroxysmal atrial fibrillation: comparison between atorvastatin and pravastatin.亲脂性或亲水性他汀类药物上游治疗对阵发性心房颤动患者抗心律失常药物的长期疗效：阿托伐他汀与普伐他汀的比较
Int Heart J. 2011;52(6):359-65. doi: 10.1536/ihj.52.359.
8
High-sensitivity C-reactive protein, statin therapy, and risks of atrial fibrillation: an exploratory analysis of the JUPITER trial.高敏 C 反应蛋白、他汀类药物治疗与心房颤动风险：JUPITER 试验的探索性分析。
Eur Heart J. 2012 Feb;33(4):531-7. doi: 10.1093/eurheartj/ehr460. Epub 2011 Dec 20.
9
Universal screening and drug treatment of dyslipidemia in children and adolescents.儿童和青少年血脂异常的普遍筛查与药物治疗。
JAMA. 2012 Jan 18;307(3):257-8. doi: 10.1001/jama.2011.1916. Epub 2011 Dec 15.
10
Statins promote the regression of atherosclerosis via activation of the CCR7-dependent emigration pathway in macrophages.他汀类药物通过激活巨噬细胞中 CCR7 依赖性迁移途径促进动脉粥样硬化的消退。
PLoS One. 2011;6(12):e28534. doi: 10.1371/journal.pone.0028534. Epub 2011 Dec 6.
Zotero 插件