Lee Su Mi, Son Young Ki, Kim Seong Eun, Kim Yeong Hoon, Park Yongsoon, An Won Suk
Department of Internal Medicine, Dong-A University, Busan, Republic of Korea.
Department of Internal Medicine, Inje University Busan Paik Hospital, Busan, Republic of Korea.
Kidney Res Clin Pract. 2021 Sep;40(3):392-400. doi: 10.23876/j.krcp.20.247. Epub 2021 May 26.
Statin treatment has decreased the risk of cardiovascular events in patients with chronic kidney disease (CKD). Erythrocyte membrane oleic acid level is higher in patients with acute coronary syndrome. This study aimed to evaluate the effect of pravastatin on the erythrocyte membrane fatty acid (FA) contents in patients with CKD.
Sixty-two patients were enrolled from January 2017 to March 2019 (NCT02992548). Pravastatin was initially administered at a dose of 20 mg for 24 weeks. The pravastatin dose was increased to 40 mg after 12 weeks if it was necessary to control dyslipidemia. The primary outcome was change in erythrocyte membrane FA, including oleic acid, after pravastatin treatment for 24 weeks.
Forty-five patients finished this study, and there was no adverse effect related to pravastatin. Compared with baseline, total cholesterol and low-density lipoprotein cholesterol levels were significantly decreased after pravastatin treatment. Compared with baseline, saturated FA, oleic acid, and arachidonic acid levels were significantly increased and polyunsaturated FA and linoleic acid (LA) levels were significantly decreased after pravastatin treatment. There was also a decrease in eicosapentaenoic acid after pravastatin treatment in CKD patients with estimated glomerular filtration rate <60 mL/min/1.73 m2.
Administration of pravastatin in patients with CKD leads to a decrease in FA known to be protective against the risk of CVD. Omega-3 FA or LA supplementation might be necessary to recover changes in erythrocyte membrane FA contents when pravastatin is used for treating dyslipidemia in patients with CKD.
他汀类药物治疗已降低了慢性肾脏病（CKD）患者发生心血管事件的风险。急性冠状动脉综合征患者的红细胞膜油酸水平较高。本研究旨在评估普伐他汀对CKD患者红细胞膜脂肪酸（FA）含量的影响。
2017年1月至2019年3月共纳入62例患者（NCT02992548）。普伐他汀初始剂量为20mg，服用24周。若有必要控制血脂异常，12周后将普伐他汀剂量增至40mg。主要结局是普伐他汀治疗24周后红细胞膜FA的变化，包括油酸。
45例患者完成本研究，未出现与普伐他汀相关的不良反应。与基线相比，普伐他汀治疗后总胆固醇和低密度脂蛋白胆固醇水平显著降低。与基线相比，普伐他汀治疗后饱和FA（SFA）、油酸和花生四烯酸水平显著升高，多不饱和FA（PUFA）和亚油酸（LA）水平显著降低。估算肾小球滤过率<60 mL/min/1.73 m2的CKD患者在普伐他汀治疗后二十碳五烯酸也有所降低。
CKD患者服用普伐他汀会导致已知对心血管疾病风险有保护作用的FA减少。当使用普伐他汀治疗CKD患者的血脂异常时，可能需要补充ω-3 FA或LA以恢复红细胞膜FA含量的变化。
