Wu Dong-Feng, Lin Dan, Lu Feng, Liao Qin-Chen, Wu Yu-Juan, Wang Zhou, Yu Kun, Li Wei-Jun, Deng Jin-Long
Department of the Geriatric Cardiology, People's Hospital of Guangxi Zhuang Autonomous Region, Nanning 530021, Guangxi, People's Republic of China.
Department of the First Comprehensive Clinic, The Affiliated Stomatology Hospital of Guangxi Medical University, Nanning 530021, Guangxi, People's Republic of China.
Pharmgenomics Pers Med. 2020 Oct 29;13:553-561. doi: 10.2147/PGPM.S273346. eCollection 2020.
Epidemiological studies have shown that there are sex differences in blood lipid levels and lipid responses to statins. Previous studies have shown that the rs5888 single nucleotide polymorphism (SNP) in the scavenger receptor class B type 1 () gene is associated with serum lipid levels in a sex-specific manner. The present study was undertaken to detect the sex-specific influence of the rs5888 SNP on the serum lipid response to atorvastatin in patients with acute coronary syndrome (ACS) undergoing percutaneous coronary intervention (PCI).
A total of 158 unrelated ACS patients (108 males, 50 females) were enrolled, and all patients received atorvastatin 20 mg/daily after PCI. Genotyping of the rs5888 SNP was performed by polymerase chain reaction and direct sequencing. Serum lipid profiles were determined before treatment and after an average follow-up time of one year.
The baseline serum total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C) and apolipoprotein (Apo)AI levels were higher in females than in males (P<0.05). After treatment with atorvastatin, serum TC, LDL-C, and ApoB were decreased, and ApoAI was increased (P<0.05). The effects of atorvastatin on serum lipid levels were different between males and females, and females had greater decreases in TC, LDL-C and ApoB levels than males (P<0.05). The genotypic frequencies of the rs5888 SNP were not different between males and females. The atorvastatin response was not associated with the rs5888 SNP in males (P > 0.05). Nonetheless, in female individuals carrying the rs5888 T-allele, we observed a greater reduction in TC, LDL-C, and ApoB levels after the use of 20 mg/day atorvastatin (P<0.05).
This study indicates that the rs5888 T-allele was associated with a greater reduction in serum TC, LDL-C, and ApoB after atorvastatin treatment in female patients with ACS undergoing PCI.
流行病学研究表明，血脂水平及血脂对他汀类药物的反应存在性别差异。既往研究显示，清道夫受体B1型（SR-B1）基因中的rs5888单核苷酸多态性（SNP）以性别特异性方式与血脂水平相关。本研究旨在检测rs5888 SNP对接受经皮冠状动脉介入治疗（PCI）的急性冠状动脉综合征（ACS）患者血清脂质对阿托伐他汀反应的性别特异性影响。
共纳入158例无亲缘关系的ACS患者（男性108例，女性50例），所有患者在PCI术后接受阿托伐他汀20 mg/每日治疗。通过聚合酶链反应和直接测序对rs5888 SNP进行基因分型。在治疗前及平均随访1年后测定血清脂质谱。
女性患者的基线血清总胆固醇（TC）、低密度脂蛋白胆固醇（LDL-C）、高密度脂蛋白胆固醇（HDL-C）和载脂蛋白（Apo）AI水平高于男性（P<0.05）。阿托伐他汀治疗后，血清TC、LDL-C和ApoB降低，ApoAI升高（P<0.05）。阿托伐他汀对血清脂质水平的影响在男性和女性之间存在差异，女性患者的TC、LDL-C和ApoB水平下降幅度大于男性（P<0.05）。rs5888 SNP的基因型频率在男性和女性之间无差异。阿托伐他汀反应与男性患者的rs5888 SNP无关（P>0.05）。然而，在携带rs5888 T等位基因的女性个体中，我们观察到使用20 mg/d阿托伐他汀后TC、LDL-C和ApoB水平下降幅度更大（P<0.05）。
本研究表明，rs5888 T等位基因与接受PCI的女性ACS患者在阿托伐他汀治疗后血清TC、LDL-C和ApoB的更大幅度降低相关。
