Zabihi Mohsen, Askarian Fatemeh, Hekmatimoghaddam Seyedhossein, Rashidi Nooshabadi Mohammadreza, Zabihi Mohammad Sajjad, Mousavinasab Seyed Ruhollah
Department of Pharmacology, School of Pharmacy, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
Yazd Cardiovascular Research Center, Afshar Hospital, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
Adv Pharmacol Pharm Sci. 2021 Dec 29;2021:5539595. doi: 10.1155/2021/5539595. eCollection 2021.
Myopathy is one of the side effects of lipid-lowering drugs, especially statins and particularly when combined with a fibrate. To diagnose myopathy and determine its severity, the plasma levels of three enzymes, creatine kinase (CK), aldolase, and lactate dehydrogenase (LDH), are routinely measured. Physical exercise can aggravate the statin-associated muscular disease. The question is whether antioxidants like ascorbic acid (Vit. C) can prevent such myopathy.
In this experiment, a combination of atorvastatin (ATV, 80 mg/kg/day) and gemfibrozil (GMF, 1000 mg/kg/day) orally for 10 days as well as exercise as forced swimming on days 8, 9, and 10 were used to induce myopathy. Ascorbic acid (50 mg/kg/day, orally) was added to ATV/GMF plus exercise regimen throughout the 10 days in the treatment group. Mean blood levels of CK, aldolase, and LDH were measured in addition to swimming tolerance times.
There was a significantly higher swimming tolerance time ( < 0.05) and lower CK levels ( < 0.01) in rats receiving ATV/GMF/Vit. C plus exercise compared with rats not taking Vit. C. LDH and aldolase did not decrease significantly.
The results of this study showed that Vit. C can be effective in preventing myopathy caused by fat-lowering drugs.
肌病是降脂药物的副作用之一,尤其是他汀类药物,特别是与贝特类药物合用时。为了诊断肌病并确定其严重程度,通常会检测三种酶,即肌酸激酶(CK)、醛缩酶和乳酸脱氢酶(LDH)的血浆水平。体育锻炼会加重他汀类药物相关的肌肉疾病。问题是抗氧化剂如抗坏血酸(维生素C)是否能预防此类肌病。
在本实验中,采用阿托伐他汀(ATV,80mg/kg/天)和吉非贝齐(GMF,1000mg/kg/天)联合口服10天,并在第8、9和10天进行强迫游泳运动来诱导肌病。在治疗组中,在整个10天的ATV/GMF加运动方案中加入抗坏血酸(50mg/kg/天,口服)。除了测量游泳耐受时间外,还测量了CK、醛缩酶和LDH的平均血药浓度。
与未服用维生素C的大鼠相比,接受ATV/GMF/维生素C加运动的大鼠游泳耐受时间显著延长(<0.05),CK水平降低(<0.01)。LDH和醛缩酶没有显著降低。
本研究结果表明,维生素C可有效预防降脂药物引起的肌病。