Department of Biochemistry, Sri Venkateswara Institute of Medical Sciences, Tirupati, Andhra Pradesh, 517507, India.
Department of Endocrinology and Metabolism, Sri Venkateswara Institute of Medical Sciences, Tirupati, Andhra Pradesh, 517507, India.
Endocrine. 2021 Jan;71(1):76-86. doi: 10.1007/s12020-020-02472-5. Epub 2020 Sep 7.
High-density lipoprotein (HDL) undergoes structural and functional modification in patients with type 2 diabetes mellitus (T2DM). There are limited data on effect of rosuvastatin on HDL-associated proteins and the antiatherogenic effects of rosuvastatin. The present study intended to study the efficacy of rosuvastatin intervention on HDL-associated proteins and its other antiatherogenic effects in men with T2DM.
Men with T2DM on oral antidiabetic treatment, with LDL-C levels > 75 mg/dL and willing for rosuvastatin intervention (20 mg/day orally for a period of 12 weeks), were included. Fasting glucose, lipid profile were measured using standard methods. Oxidized low-density lipoprotein (oxLDL), oxidized HDL (oxHDL), paraoxonase-1 (PON-1), tumour necrosis factor-α (TNF-α) and lecithin:cholesterol acyltransferase (LCAT) in serum were measured by ELISA; serum myeloperoxidase (MPO) by spectrophotometric method and cholesterol efflux by fluorometric assay. Carotid intima-media thickness (cIMT) measurement to assess vascular health status was done using doppler.
Rosuvastatin produced a significant decrease (p < 0.05) in lipids (total cholesterol, triglycerides, LDL-C); oxidative stress (oxLDL, oxHDL, MPO); inflammation (TNF-α); LCAT concentration; cIMT; significant increase in antiatherogenic HDL and cholesterol efflux (p < 0.05) and no change in apoA-I levels from baseline to 12 weeks of follow-up. A decrease in MPO activity was found to be independently associated with an increase in cholesterol efflux.
Post intervention there is a quantitative and qualitative improvement in HDL, which helps in its reverse cholesterol transport (RCT) and antioxidant functions. Improvement in HDL functions and suppression of inflammation by rosuvastatin lead to regression in cIMT, which is beneficial in decreasing the progression of cardiovascular disease (CVD) in men with diabetes.
高密度脂蛋白（HDL）在 2 型糖尿病（T2DM）患者中会发生结构和功能改变。关于瑞舒伐他汀对 HDL 相关蛋白的影响以及瑞舒伐他汀的抗动脉粥样硬化作用，目前的数据有限。本研究旨在研究瑞舒伐他汀干预对 T2DM 男性 HDL 相关蛋白的疗效及其其他抗动脉粥样硬化作用。
纳入口服降糖药物治疗的 T2DM 男性患者，LDL-C 水平＞75mg/dL，并愿意接受瑞舒伐他汀干预（20mg/天，口服，持续 12 周）。使用标准方法测量空腹血糖和血脂谱。使用 ELISA 法测定血清中氧化型低密度脂蛋白（oxLDL）、氧化型高密度脂蛋白（oxHDL）、对氧磷酶-1（PON-1）、肿瘤坏死因子-α（TNF-α）和卵磷脂胆固醇酰基转移酶（LCAT）；用分光光度法测定血清髓过氧化物酶（MPO）；用荧光法测定胆固醇流出率。使用多普勒超声测量颈动脉内膜中层厚度（cIMT）以评估血管健康状况。
瑞舒伐他汀治疗可显著降低（p＜0.05）血脂（总胆固醇、甘油三酯、LDL-C）；氧化应激（oxLDL、oxHDL、MPO）；炎症（TNF-α）；LCAT 浓度；cIMT；显著增加抗动脉粥样硬化的 HDL 和胆固醇流出率（p＜0.05），而从基线到 12 周随访时载脂蛋白 A-I 水平没有变化。MPO 活性的降低与胆固醇流出率的增加独立相关。
干预后，HDL 的数量和质量都有所改善，有助于其逆胆固醇转运（RCT）和抗氧化功能。瑞舒伐他汀改善 HDL 功能和抑制炎症可使 cIMT 消退，这有利于降低糖尿病男性心血管疾病（CVD）的进展。
