Department of Medicine & Therapeutics, The Chinese University of Kong Kong, Shatin, Hong Kong SAR, China.
Pharmacogenomics. 2013 Aug;14(11):1283-94. doi: 10.2217/pgs.13.115.
This study examined whether the ABCG2 421C>A polymorphism and variants in other genes potentially related to the pharmacokinetics of rosuvastatin influenced the plasma concentration of rosuvastatin in Chinese patients with hypercholesterolemia.
PATIENTS & METHODS: Overnight fasting blood samples were collected from 291 patients who had received a rosuvastatin 10 mg night-time dose for at least 4 weeks. Plasma concentrations of rosuvastatin and N-desmethyl rosuvastatin were quantified using liquid chromatography tandem mass spectrometry.
In subjects with the ABCG2 421AA genotype (n = 39), the mean plasma concentrations of rosuvastatin and its metabolite were 63 and 41% greater than the values in those with the 421CA genotype (n = 108) and 120 and 99% greater than in those with the 421CC genotype (n = 129). The plasma concentrations of rosuvastatin were associated (r = -0.194; p = 0.001) with the percentage reduction in low-density lipoprotein cholesterol with rosuvastatin, but the association was not significant after adjusting for the ABCG2 421C>A polymorphism. The SLCO1B1 521T>C polymorphism was associated with increased plasma concentrations of rosuvastatin and impaired N-demethylation of rosuvastatin, but had no impact on its lipid-lowering effect. Polymorphisms in CYP2C9, CYP2C19 and SLC10A1 had minimal effects.
These findings suggest that the increased plasma concentrations of rosuvastatin in Chinese patients are associated with increased lipid-lowering effects and lower doses of rosuvastatin should be effective in subjects with the ABCG2 421C>A variant.
本研究旨在探讨 ABCG2 421C>A 多态性以及其他可能与瑞舒伐他汀药代动力学相关的基因变异是否会影响中国高胆固醇血症患者中瑞舒伐他汀的血浆浓度。
收集 291 例接受瑞舒伐他汀 10mg 夜间剂量至少 4 周的患者的隔夜禁食血样。采用液相色谱串联质谱法定量检测瑞舒伐他汀和 N-去甲基瑞舒伐他汀的血浆浓度。
在 ABCG2 421AA 基因型(n = 39)患者中,瑞舒伐他汀及其代谢物的平均血浆浓度比 421CA 基因型(n = 108)患者高 63%,比 421CC 基因型(n = 129)患者高 120%。瑞舒伐他汀的血浆浓度与瑞舒伐他汀降低低密度脂蛋白胆固醇的百分比相关(r = -0.194;p = 0.001),但在调整 ABCG2 421C>A 多态性后,这种相关性不再显著。SLCO1B1 521T>C 多态性与瑞舒伐他汀的血浆浓度升高和瑞舒伐他汀去甲基化受损相关,但对其降脂作用没有影响。CYP2C9、CYP2C19 和 SLC10A1 多态性的影响较小。
这些发现表明,中国患者瑞舒伐他汀的血浆浓度升高与降脂作用增强相关,对于 ABCG2 421C>A 变异患者,应使用较低剂量的瑞舒伐他汀。