Meor Anuar Shuhaili Meor Fairuz Rizal, Samsudin Intan Nureslyna, Stanslas Johnson, Hasan Shariful, Thambiah Subashini C
Department of Pathology, Faculty of Medicine and Health Sciences, University Putra Malaysia, 43400 UPM Serdang, Selangor Darul Ehsan, Malaysia.
Department of Medicine, Faculty of Medicine and Health Sciences, University Putra Malaysia, 43400 UPM Serdang, Selangor Darul Ehsan, Malaysia.
Int J Endocrinol Metab. 2017 Apr 22;15(2):e43319. doi: 10.5812/ijem.43319. eCollection 2017 Apr.
The present review aimed at reviewing the effects of different statins on lipid profile, particularly in Asians.
PubMed searches were conducted using the keywords 'statin, effect, and lipid profile' from database inception through March 2016. In this review, 718 articles were retrieved from the primary search. After reviewing the titles, abstracts, and full texts, we found that 59 studies met our inclusion criteria. These also included subsequent reference searches of retrieved articles.
CURVES study compared the effect on lipid profile between atorvastatin and other statins. This study demonstrated that low-density lipoprotein cholesterol (LDL-C), total cholesterol (TC), and triglycerides (TG) were reduced more with atorvastatin compared to simvastatin, pravastatin, lovastatin, and fluvastatin. However, simvastatin provided a greater elevation of high-density lipoprotein cholesterol (HDL-C) compared to atorvastatin. The STELLAR trial was based on dose-to-dose comparisons between atorvastatin and rosuvastatin efficacy in reducing LDL-C. Te present study also revealed that as the doses of rosuvastatin, simvastatin, and pravastatin increased, HDL-C also increased, with rosuvastatin having the greatest effect. However, HDL-C levels decreased as the dose of atorvastatin increased. The DISCOVERY study involving the Asian population revealed that the percentage of patients achieving the European goals for LDL-C and TC at 12 weeks was higher in rosuvastatin group compared to atorvastatin group.
The effects of statins on lipid profile are dose dependent. Most studies showed that rosuvastatin has the best effect on lipid profile. Prescribing lower doses of statins in Asians seems necessary.
本综述旨在回顾不同他汀类药物对血脂谱的影响，尤其是对亚洲人的影响。
从数据库建立至2016年3月，使用关键词“他汀类药物、作用和血脂谱”在PubMed上进行检索。在本综述中，通过初步检索获得718篇文章。在审阅标题、摘要和全文后，我们发现有59项研究符合纳入标准。这还包括对检索到的文章进行后续参考文献检索。
CURVES研究比较了阿托伐他汀与其他他汀类药物对血脂谱的影响。该研究表明，与辛伐他汀、普伐他汀、洛伐他汀和氟伐他汀相比，阿托伐他汀降低低密度脂蛋白胆固醇（LDL-C）、总胆固醇（TC）和甘油三酯（TG）的效果更佳。然而，与阿托伐他汀相比，辛伐他汀使高密度脂蛋白胆固醇（HDL-C）升高的幅度更大。STELLAR试验基于阿托伐他汀和瑞舒伐他汀降低LDL-C疗效的逐剂量比较。本研究还显示，随着瑞舒伐他汀、辛伐他汀和普伐他汀剂量的增加，HDL-C也升高，其中瑞舒伐他汀的作用最为显著。然而，随着阿托伐他汀剂量的增加，HDL-C水平降低。涉及亚洲人群的DISCOVERY研究表明，与阿托伐他汀组相比，瑞舒伐他汀组在12周时达到欧洲LDL-C和TC目标的患者百分比更高。
他汀类药物对血脂谱的影响具有剂量依赖性。大多数研究表明，瑞舒伐他汀对血脂谱的效果最佳。在亚洲人当中，开具较低剂量的他汀类药物似乎很有必要。
