Department of Internal Medicine, Eulji General Hospital.
Department of Internal Medicine, Seoul National University Bundang Hospital.
Circ J. 2018 Apr 25;82(5):1387-1395. doi: 10.1253/circj.CJ-17-0411. Epub 2017 Sep 22.
Quality and quantity of high-density lipoprotein cholesterol (HDL-C) may be associated with cardiovascular risk. We investigated the effect of rosuvastatin on cholesterol efflux (CE) for HDL function and vascular health.
We enrolled 30 dyslipidemic patients with type 2 diabetes mellitus and 20 healthy subjects as controls. Vascular health was assessed on flow-medicated dilation (FMD), nitroglycerin-induced dilatation of the brachial artery and carotid artery intima-media thickness (cIMT). These parameters were compared between patients and controls, and between baseline and at 12 weeks of treatment with rosuvastatin 20 mg. Age and body mass index were 49.8±11.3 years and 25.8±3.7 kg/min the patients, and 28.8±3.2 years and 22.4±2.4 kg/min the controls, respectively. The biomarkers related to lipid and glucose metabolism and lipoprotein (a), high-sensitivity C-reactive protein, and cIMT were significantly higher, and CE and FMD were significantly lower in the patients than in the controls. In the patients, rosuvastatin 20 mg decreased low-density lipoprotein cholesterol by 54.1% and increased HDL-C by 4.8%. The CE increased significantly after rosuvastatin treatment (12.26±2.72% vs. 14.05±4.14%). FMD also increased, and lipoprotein (a) and cIMT decreased significantly and were associated with changes of CE.
Rosuvastatin-induced changes in HDL function are significantly associated with cardiovascular benefit.
高密度脂蛋白胆固醇(HDL-C)的质量和数量可能与心血管风险有关。我们研究了瑞舒伐他汀对 HDL 功能和血管健康的胆固醇外排(CE)的影响。
我们纳入了 30 名 2 型糖尿病伴血脂异常患者和 20 名健康对照者。血管健康通过血流介导的扩张(FMD)、肱动脉和颈动脉内中膜厚度(cIMT)的硝酸甘油诱导扩张来评估。将这些参数在患者和对照组之间、基线和瑞舒伐他汀 20mg 治疗 12 周之间进行比较。患者的年龄和体重指数分别为 49.8±11.3 岁和 25.8±3.7kg/min,对照组分别为 28.8±3.2 岁和 22.4±2.4kg/min。与脂质和葡萄糖代谢以及脂蛋白(a)、高敏 C 反应蛋白和 cIMT 相关的生物标志物在患者中显著升高,而 CE 和 FMD 显著降低。瑞舒伐他汀 20mg 使患者的低密度脂蛋白胆固醇降低 54.1%,HDL-C 升高 4.8%。瑞舒伐他汀治疗后 CE 显著增加(12.26±2.72% vs. 14.05±4.14%)。FMD 也增加,脂蛋白(a)和 cIMT 显著降低,与 CE 的变化相关。
瑞舒伐他汀诱导的 HDL 功能变化与心血管获益显著相关。