Kim Minna, Kim Seong Eun, Lee Su Mi, An Won Suk
Department of Internal Medicine, Dong-A University College of Medicine, Busan, Korea.
Medical Science Research Center, Dong-A University, Busan, Korea.
J Yeungnam Med Sci. 2024 Jul;41(3):188-195. doi: 10.12701/jyms.2024.00094. Epub 2024 May 8.
Statins reduce the risk of cardiovascular events in patients with chronic kidney disease (CKD). Although diabetes mellitus (DM) is a reported side effect of statin treatment, some studies have indicated that pitavastatin does not cause DM. The present study investigated the effect of pitavastatin on the fatty acid (FA) content of erythrocyte membranes, which affects the occurrence of DM and cardiovascular diseases. In addition, changes in adiponectin and glycated hemoglobin (HbA1c) levels were evaluated after pitavastatin treatment.
A total of 45 patients were enrolled, 28 of whom completed the study. Over 24 weeks, 16 patients received 2 mg pitavastatin and 12 patients received 10 mg atorvastatin. Dosages were adjusted after 12 weeks if additional lipid control was required. There were 10 and nine patients with DM in the pitavastatin and atorvastatin groups, respectively. Erythrocyte membrane FAs and adiponectin levels were measured using gas chromatography and enzyme-linked immunosorbent assay, respectively.
In both groups, saturated FAs, palmitic acid, trans-oleic acid, total cholesterol, and low-density lipoprotein cholesterol levels were significantly lower than those at baseline. The arachidonic acid (AA) content in the erythrocyte membrane increased significantly in the pitavastatin group, but adiponectin levels were unaffected. HbA1c levels decreased in patients treated with pitavastatin. No adverse effects were associated with statin treatment.
Pitavastatin treatment in patients with CKD may improve glucose metabolism by altering erythrocyte membrane AA levels. In addition, pitavastatin did not adversely affect glucose control in patients with CKD and DM.
他汀类药物可降低慢性肾脏病(CKD)患者发生心血管事件的风险。虽然糖尿病(DM)是他汀类药物治疗的一种已知副作用,但一些研究表明匹伐他汀不会导致糖尿病。本研究调查了匹伐他汀对红细胞膜脂肪酸(FA)含量的影响,这会影响糖尿病和心血管疾病的发生。此外,还评估了匹伐他汀治疗后脂联素和糖化血红蛋白(HbA1c)水平的变化。
共纳入45例患者,其中28例完成研究。在24周内,16例患者接受2mg匹伐他汀治疗,12例患者接受10mg阿托伐他汀治疗。如果需要进一步控制血脂,则在第12周后调整剂量。匹伐他汀组和阿托伐他汀组分别有10例和9例糖尿病患者。分别采用气相色谱法和酶联免疫吸附测定法测定红细胞膜脂肪酸和脂联素水平。
两组患者的饱和脂肪酸、棕榈酸、反式油酸、总胆固醇和低密度脂蛋白胆固醇水平均显著低于基线水平。匹伐他汀组红细胞膜中花生四烯酸(AA)含量显著增加,但脂联素水平未受影响。接受匹伐他汀治疗的患者HbA1c水平降低。他汀类药物治疗未出现不良反应。
CKD患者接受匹伐他汀治疗可能通过改变红细胞膜AA水平改善糖代谢。此外,匹伐他汀对CKD合并DM患者的血糖控制无不良影响。