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短期添加依折麦布对合并糖尿病和血脂异常的患者脂联素和炎症标志物表达的影响。

Effects of short-term add-on ezetimibe to statin treatment on expression of adipokines and inflammatory markers in diabetic and dyslipidemic patients.

机构信息

Department of Clinical and Toxicological Analysis, School of Pharmaceutical Sciences, University of Sao Paulo, Sao Paulo, Brazil.

Center of Excellence in Translational Medicine, CETM-BIOREN, Department of Basic Sciences, Universidad de La Frontera, Temuco, Chile.

出版信息

Cardiovasc Ther. 2017 Dec;35(6). doi: 10.1111/1755-5922.12307. Epub 2017 Oct 4.

Abstract

AIM

The influence of short-term add-on ezetimibe to simvastatin treatment on expression of adipokines and inflammatory markers was investigated in diabetic and nondiabetic patients with hypercholesterolemia.

METHOD

Hypercholesterolemic nondiabetic (HC, n = 37) and diabetic (DM, n = 47) patients were treated with simvastatin (SV, 10 or 20 mg/d/8-wk) and then SV plus ezetimibe (SV + EZ, 10 mg each/d/4 wk). Serum lipids, glycemic profile, and inflammatory markers (hsCRP, adiponectin, resistin, VCAM-1, and ICAM-1) were evaluated before and after the add-on ezetimibe therapy. mRNA expression of ADIPOR1, ADIPOR2, RETN, VCAM1, and ICAM1 was measured by real-time PCR in peripheral blood mononuclear cells (PBMC).

RESULTS

Serum concentrations of LDL and HDL cholesterol, and adiponectin were higher in HC than DM patients (P < .05). The add-on ezetimibe therapy reduced total and LDL cholesterol, apoB and adiponectin serum levels in HC and DM groups, and resistin in HC subjects (P < .05). DM patients showed higher expression of ADIPOR1, ADIPOR2, RETN, and VCAM1 in PBMC than subjects in HC group, before and after add-on ezetimibe therapy (P < .05). PBMC RETN mRNA expression was reduced by add-on ezetimibe therapy in HC individuals (P < .05), but not in DM subjects.

CONCLUSION

Short-term add-on ezetimibe to simvastatin treatment suppressing effects on hypercholesterolemia and adiponectinemia is independent of the diabetes status. Resistin serum levels and leukocyte mRNA expression are influenced by add-on ezetimibe to statin treatment.

摘要

目的

研究短期添加依折麦布对辛伐他汀治疗的影响在糖尿病和非糖尿病高胆固醇血症患者的脂联素和炎症标志物的表达。

方法

高胆固醇血症非糖尿病(HC,n=37)和糖尿病(DM,n=47)患者用辛伐他汀(SV,10 或 20mg/d/8 周)治疗,然后添加依折麦布(SV+EZ,10mg/d/4 周)。在添加依折麦布治疗前后,检测血清脂质、血糖谱和炎症标志物(hsCRP、脂联素、抵抗素、VCAM-1 和 ICAM-1)。通过实时 PCR 测定外周血单核细胞(PBMC)中 ADIPOR1、ADIPOR2、RETN、VCAM1 和 ICAM1 的 mRNA 表达。

结果

HC 患者的 LDL 和 HDL 胆固醇以及脂联素血清浓度高于 DM 患者(P<.05)。添加依折麦布治疗降低了 HC 和 DM 组的总胆固醇和 LDL 胆固醇、载脂蛋白 B 和脂联素血清水平,以及 HC 组的抵抗素(P<.05)。与 HC 组相比,DM 患者的 PBMC 中 ADIPOR1、ADIPOR2、RETN 和 VCAM1 的表达更高,添加依折麦布治疗前后(P<.05)。添加依折麦布治疗降低了 HC 个体的 PBMC RETN mRNA 表达(P<.05),但在 DM 患者中没有。

结论

短期添加依折麦布对辛伐他汀治疗的抑制作用对高胆固醇血症和脂联素血症的影响与糖尿病状态无关。抵抗素血清水平和白细胞 mRNA 表达受添加依折麦布对他汀类药物治疗的影响。

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