de Souza Zago Vanessa Helena, Tanus-Santos José Eduardo, Gardin Danelon Mirian Regina, Parra Eliane Soler, Alexandre Fernanda, Vieira Isabela Calanca, Panzoldo Natália Baratella, D'Alexandri Fábio Luís, Rocha Quintão Eder Carlos, de Faria Eliana Cotta
Int J Clin Pharmacol Ther. 2014 Apr;52(4):277-83. doi: 10.5414/CP201742.
Regardless of its effect on the concentrations of serum cholesterol, statins exert pleiotropic effects, including the regulation of endothelial function, reduced oxidative stress and inflammation, as well as a slight improvement in the concentrations of high density lipoprotein (HDL). However, its role on the composition of HDL is not yet established. The aim of this study was to evaluate the composition of HDL subfractions, HDLsub>2 and HDL3, after 14 days of placebo and atorvastatin (10 mg/day) use in 30 asymptomatic volunteers. The serum parameters and the HDL subfractions compositions were determined using radiometric, nephelometric and biochemical enzymatic methods. We observed significant reductions of total cholesterol, low density lipoprotein (LDL) and apolipoprotein B-100 by 28%, 40% and 38%, respectively. The analyses of chemical composition of the subfractions revealed a lower lipid protein ratio in HDL2, suggesting enrichment in proteins, and also lower in HDL3, probably by an increase in the number of particles. Several mechanisms can be suggested for the effects observed after the use of atorvastatin, such as a possible action on the reverse cholesterol transport (decreased activity of hepatic lipase and increased phospholipid transfer protein, PLTP), which would explain the enrichment of HDL. The results suggest that statin use may be relevant in the primary prevention of atherosclerosis not only by its lowering effect on LDLcholesterol and its anti-inflammatory effect but also by beneficial changes in HDL subfractions.
无论他汀类药物对血清胆固醇浓度有何影响，它们都具有多效性作用，包括调节内皮功能、减轻氧化应激和炎症，以及使高密度脂蛋白（HDL）浓度略有升高。然而，其对HDL组成的作用尚未明确。本研究的目的是评估30名无症状志愿者在服用安慰剂和阿托伐他汀（10毫克/天）14天后HDL亚组分HDL2和HDL3的组成。使用放射测量法、散射比浊法和生化酶法测定血清参数和HDL亚组分组成。我们观察到总胆固醇、低密度脂蛋白（LDL）和载脂蛋白B - 100分别显著降低了28%、40%和38%。亚组分化学成分分析显示，HDL2中的脂蛋白比率较低，表明蛋白质含量增加，HDL3中的脂蛋白比率也较低，可能是由于颗粒数量增加。对于使用阿托伐他汀后观察到的效果，可以提出几种机制，例如可能对逆向胆固醇转运有作用（肝脂酶活性降低和磷脂转运蛋白PLTP增加），这可以解释HDL的富集。结果表明，他汀类药物的使用可能不仅通过其降低LDL胆固醇的作用和抗炎作用，而且通过HDL亚组分的有益变化，在动脉粥样硬化的一级预防中具有重要意义。
