Cardiovascular Research Institute, University of California, San Francisco, San Francisco, CA, USA.
Cardiovascular Research Institute, University of California, San Francisco, San Francisco, CA, USA; Department of Medicine, University of California, San Francisco, San Francisco, CA, USA.
J Clin Lipidol. 2017 Jul-Aug;11(4):908-914. doi: 10.1016/j.jacl.2017.04.118. Epub 2017 May 4.
Elevated plasma levels of prebeta-1 high-density lipoprotein (HDL), the principal acceptor of cholesterol effluxed from macrophages, are associated with increased risk of atherosclerotic coronary heart disease and myocardial infarction.
The objective of the study was to assess the effects on prebeta-1 HDL levels of 6-week moderate-dose statin treatment.
We studied 101 patients (mean age 52.7 years; 53.5% female; 63 with primary hypercholesterolemia; 38 with combined hyperlipidemia) before and after treatment with statins. Mean atorvastatin potency equivalence was 23.6 mg/d. Prebeta-1 HDL plasma levels were measured by immunofixation of agarose gels using anti-apolipoprotein A-1 antibody.
We observed a 42.0% reduction of low-density lipoprotein cholesterol (181 ± 56 vs 105 mg/dL, P < .001). Triglyceride (TG) levels decreased by 22.3% (157 vs 122 mg/dL, P < .001), HDL cholesterol levels remained similar (56.0 vs 57.1, P = NS). Levels of prebeta-1 HDL were significantly reduced by 17.9% after statin treatment (mean 11.4 vs 9.4 mg apoA-1/dL, P < .001). The magnitude of this decrease was similar with each of 3 statins (atorvastatin, simvastatin, and rosuvastatin). The decrease in prebeta-1 HDL was strongly associated with the decline in TG, but not with the decline in low-density lipoprotein cholesterol.
The association of high prebeta-1 HDL with coronary heart disease identifies it as an inferential measure of the rate of cholesterol efflux from the artery wall. Our observations demonstrate a reduction of prebeta-1 HDL with statin therapy, partially reflecting the reduced TGs, and probably reflecting a direct beneficial impact on cholesterol efflux.
β-1 前高密度脂蛋白（HDL）是巨噬细胞内胆固醇流出的主要接受体，其血浆水平升高与动脉粥样硬化性冠心病和心肌梗死的风险增加相关。
本研究旨在评估 6 周中等剂量他汀类药物治疗对β-1 前 HDL 水平的影响。
我们在接受他汀类药物治疗前后研究了 101 例患者（平均年龄 52.7 岁；53.5%为女性；63 例为原发性高胆固醇血症；38 例为混合性脂质血症）。阿托伐他汀的平均效价等价物为 23.6mg/d。β-1 前 HDL 血浆水平通过琼脂糖凝胶免疫固定用抗载脂蛋白 A-1 抗体进行测量。
我们观察到 LDL 胆固醇降低了 42.0%（181±56 与 105mg/dL，P<0.001）。甘油三酯（TG）水平降低了 22.3%（157 与 122mg/dL，P<0.001），HDL 胆固醇水平保持相似（56.0 与 57.1，P=NS）。他汀类药物治疗后β-1 前 HDL 水平显著降低 17.9%（平均 11.4 与 9.4mg apoA-1/dL，P<0.001）。3 种他汀类药物（阿托伐他汀、辛伐他汀和瑞舒伐他汀）的降低幅度相似。β-1 前 HDL 的降低与 TG 的降低密切相关，但与 LDL 胆固醇的降低无关。
高β-1 前 HDL 与冠心病相关，将其确定为动脉壁胆固醇流出率的推断性测量指标。我们的观察结果表明，他汀类药物治疗可降低β-1 前 HDL，部分反映了 TG 的降低，可能反映了对胆固醇流出的直接有益影响。
