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在冠心病患者中,瑞舒伐他汀联合补充锌和硒并不能增强其降血脂及多效性作用:一项双盲随机对照研究。

The hypolipidemic and pleiotropic effects of rosuvastatin are not enhanced by its association with zinc and selenium supplementation in coronary artery disease patients: a double blind randomized controlled study.

作者信息

Sena-Evangelista Karine Cavalcanti Maurício, Pedrosa Lucia Fatima Campos, Paiva Maria Sanali Moura Oliveira, Dias Paula Cristina Silveira, Ferreira Diana Quitéria Cabral, Cozzolino Sílvia Maria Franciscato, Faulin Tanize Espírito Santo, Abdalla Dulcinéia Saes Parra

机构信息

Department of Nutrition, Federal University of Rio Grande do Norte, Natal, RN, Brazil.

Onofre Lopes University Hospital, Federal University of Rio Grande do Norte, Natal, RN, Brazil.

出版信息

PLoS One. 2015 Mar 18;10(3):e0119830. doi: 10.1371/journal.pone.0119830. eCollection 2015.

Abstract

OBJECTIVE

Statins treatment may modify the levels of zinc and selenium, minerals that can improve vascular function and reduce oxidative damage and inflammation in atherosclerotic patients. This study aimed to evaluate the effects of rosuvastatin, alone or associated with zinc and selenium supplementation, on lipid profile, antioxidant enzymes and mineral status in coronary artery disease patients.

MATERIAL AND METHODS

A double-blind randomized clinical trial was performed in which patients (n = 76) were treated with 10 mg rosuvastatin over 4 months associated or not with zinc (30 mg/d) and selenium (150 μg/d) supplementation. The following parameters were analyzed before and after the intervention: anthropometric measurements, lipid profile, high sensitivity C-reactive protein (hs-CRP), electronegative low density lipoprotein (LDL(-)) concentrations, activities of glutathione peroxidase (GPx), superoxide dismutase (SOD), zinc and selenium concentrations in blood plasma and erythocytes. Significance was determined using an α of 5% (two-tailed).

RESULTS

We found that rosuvastatin therapy was efficient in reducing total cholesterol, LDL-cholesterol, non-HDL cholesterol, triglycerides, and hs-CRP independently of mineral supplementation. Neither treatment was associated with significant changes in LDL(-). Similarly, the antioxidant enzymes GPx and SOD activity were unchanged by treatments. Neither treatment was associated with significant differences in concentrations of zinc or selenium in blood plasma and erythocytes of studied groups.

CONCLUSION

Rosuvastatin treatment did not affect zinc and selenium levels in coronary artery disease patients. The zinc and selenium supplementation at doses used in this study did not change lipid profile or SOD and GPx activity in patients receiving rosuvastatin. Further studies should be focused on testing alternative doses and supplements in different populations to contribute for a consensus on the ideal choice of antioxidants to be used as possible complementary therapies in atherosclerotic patients.

TRIAL REGISTRATION

ClinicalTrials.gov NCT01547377.

摘要

目的

他汀类药物治疗可能会改变锌和硒的水平,这两种矿物质可改善动脉粥样硬化患者的血管功能、减少氧化损伤和炎症。本研究旨在评估瑞舒伐他汀单独使用或联合补充锌和硒对冠心病患者血脂谱、抗氧化酶和矿物质状态的影响。

材料与方法

进行了一项双盲随机临床试验,患者(n = 76)接受10 mg瑞舒伐他汀治疗4个月,同时或不同时补充锌(30 mg/d)和硒(150 μg/d)。在干预前后分析以下参数:人体测量指标、血脂谱、高敏C反应蛋白(hs-CRP)、带负电荷的低密度脂蛋白(LDL(-))浓度、谷胱甘肽过氧化物酶(GPx)、超氧化物歧化酶(SOD)活性、血浆和红细胞中的锌和硒浓度。使用双侧5%的α水平确定显著性。

结果

我们发现,无论是否补充矿物质,瑞舒伐他汀治疗在降低总胆固醇、低密度脂蛋白胆固醇、非高密度脂蛋白胆固醇、甘油三酯和hs-CRP方面均有效。两种治疗均未使LDL(-)发生显著变化。同样,治疗后抗氧化酶GPx和SOD的活性未改变。两种治疗均未使研究组血浆和红细胞中的锌或硒浓度出现显著差异。

结论

瑞舒伐他汀治疗不影响冠心病患者的锌和硒水平。本研究中使用的锌和硒补充剂量未改变接受瑞舒伐他汀治疗患者的血脂谱或SOD及GPx活性。进一步的研究应集中于在不同人群中测试替代剂量和补充剂,以便就将抗氧化剂作为动脉粥样硬化患者可能的辅助治疗的理想选择达成共识。

试验注册

ClinicalTrials.gov NCT01547377

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8646/4365008/876fa46d88ec/pone.0119830.g001.jpg

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