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CYP2C9基因多态性是瑞舒伐他汀治疗疗效的潜在预测标志物。

CYP2C9 Genetic Polymorphism is a Potential Predictive Marker for the Efficacy of Rosuvastatin Therapy.

作者信息

Lin Jiayao, Zhang Yu, Zhou Houguang, Wang Xinqing, Wang Wenwen

出版信息

Clin Lab. 2015;61(9):1317-24. doi: 10.7754/clin.lab.2015.150123.

Abstract

BACKGROUND

There is well-known inter-individual variability in the cholesterol-lowering effect of statins. However, inter-individual variability in response to rosuvastatin treatment in subjects with hypercholesterolemia has not been clearly established. This study aimed to evaluate the associations of CYP2C9 genetic polymorphism with the efficacy and safety of rosuvastatin in Chinese patients with hyperlipidemia.

METHODS

A total of 218 patients with hyperlipidemia were selected and treated with 10 mg rosuvastatin per day for 12 weeks. Blood samples were collected prior to the treatment and after 4, 8, and 12 weeks of treatment. Clinical biochemistry analyses for serum lipid profiles were performed. Genotyping for CYP2C9 polymorphisms was performed using allele-specific real-time PCR.

RESULTS

197 out of 218 patients featured a wild-type CYP2C9*1/1 genotype, and 21 patients featured a CYP2C91/3 or CYP2C93/3 mutation genotype. No patients with CYP2C92 alleles were identified. Sixteen patients discontinued the medication due to adverse effects. No serious adverse events (i.e., hepatotoxicity or myolysis) were observed. After the 12 weeks of treatment, we observed significant reductions in total cholesterol (TC), triglycerides and low-density lipoprotein (LDL) levels compared to baseline (p < 0.05). Patients with the mutant genotype showed a higher TC-lowering and LDL-lowing effect compared to those with wild-type genotypes (TC: 45.05% vs. 38.96%, p = 0.041; LDL: 44.97% vs. 39.28%, p = 0.029). The frequency of adverse drug reactions in the studied patients did not differ by CYP2C9 genotypes (p > 0.05).

CONCLUSIONS

This study suggests that the CYP2C9 polymorphism may be involved in the lipid-lowering efficacy of rosuvastatin in patients with hyperlipidemia.

摘要

背景

他汀类药物降低胆固醇的效果存在众所周知的个体间差异。然而,高胆固醇血症患者对瑞舒伐他汀治疗的个体间差异尚未明确确立。本研究旨在评估CYP2C9基因多态性与瑞舒伐他汀在中国高脂血症患者中的疗效和安全性之间的关联。

方法

共选取218例高脂血症患者,每天服用10mg瑞舒伐他汀,持续12周。在治疗前以及治疗4周、8周和12周后采集血样。进行血清脂质谱的临床生化分析。使用等位基因特异性实时PCR对CYP2C9基因多态性进行基因分型。

结果

218例患者中,197例具有野生型CYP2C9*1/1基因型,21例具有CYP2C91/3或CYP2C93/3突变基因型。未鉴定出携带CYP2C92等位基因的患者。16例患者因不良反应停药。未观察到严重不良事件(即肝毒性或肌溶解)。治疗12周后,与基线相比,总胆固醇(TC)、甘油三酯和低密度脂蛋白(LDL)水平显著降低(p < 0.05)。与野生型基因型患者相比,突变基因型患者的TC降低和LDL降低效果更高(TC:45.05%对38.96%,p = 0.041;LDL:44.97%对39.28%,p = 0.029)。研究患者中药物不良反应的发生率在不同CYP2C9基因型之间无差异(p > 0.05)。

结论

本研究表明,CYP2C9基因多态性可能参与瑞舒伐他汀在高脂血症患者中的降脂疗效。

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