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匹伐他汀对慢性肾脏病患者红细胞膜脂肪酸含量的影响:双臂平行随机对照试验。

Effect of pitavastatin on erythrocyte membrane fatty acid content in patients with chronic kidney disease: two-arm parallel randomized controlled trial.

作者信息

Kim Minna, Kim Seong Eun, Lee Su Mi, An Won Suk

机构信息

Department of Internal Medicine, Dong-A University College of Medicine, Busan, Korea.

Medical Science Research Center, Dong-A University, Busan, Korea.

出版信息

J Yeungnam Med Sci. 2024 Jul;41(3):188-195. doi: 10.12701/jyms.2024.00094. Epub 2024 May 8.

DOI:10.12701/jyms.2024.00094
PMID:38715530
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11294791/
Abstract

BACKGROUND

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.

METHODS

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.

RESULTS

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.

CONCLUSION

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.

摘要

背景

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。

方法

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。

结果

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。

结论

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。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cc3b/11294791/e86212547677/jyms-2024-00094f3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cc3b/11294791/f698ec0802b6/jyms-2024-00094f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cc3b/11294791/8aa60075e476/jyms-2024-00094f2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cc3b/11294791/e86212547677/jyms-2024-00094f3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cc3b/11294791/f698ec0802b6/jyms-2024-00094f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cc3b/11294791/8aa60075e476/jyms-2024-00094f2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cc3b/11294791/e86212547677/jyms-2024-00094f3.jpg

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本文引用的文献

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The Effect of Statin Therapy on Serum Uric Acid Levels: A Systematic Review and Meta-analysis.他汀类药物治疗对血尿酸水平的影响:系统评价和荟萃分析。
Curr Med Chem. 2024;31(13):1726-1739. doi: 10.2174/0929867330666230207124516.
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Syntaxin interacts with arachidonic acid to prevent diabetes mellitus.Syntaxin 与花生四烯酸相互作用以预防糖尿病。
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Impact of pitavastatin on new-onset diabetes mellitus compared to atorvastatin and rosuvastatin: a distributed network analysis of 10 real-world databases.
与阿托伐他汀和瑞舒伐他汀相比,匹伐他汀对新发糖尿病的影响:10 个真实世界数据库的分布式网络分析。
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Differential Diabetogenic Effect of Pitavastatin and Rosuvastatin, in vitro and in vivo.匹伐他汀和罗苏伐他汀的体外和体内降糖作用差异。
J Atheroscler Thromb. 2020 May 1;27(5):429-440. doi: 10.5551/jat.50039. Epub 2019 Sep 13.
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Saturated fatty acids and mortality in patients referred for coronary angiography-The Ludwigshafen Risk and Cardiovascular Health study.饱和脂肪酸与冠状动脉造影患者的死亡率:德国路德维希港风险和心血管健康研究。
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Saturated Fatty Acids and Cardiovascular Disease: Replacements for Saturated Fat to Reduce Cardiovascular Risk.饱和脂肪酸与心血管疾病:用饱和脂肪替代品降低心血管风险
Healthcare (Basel). 2017 Jun 21;5(2):29. doi: 10.3390/healthcare5020029.
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Statin-Associated Side Effects.他汀类药物相关副作用。
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Lipids Health Dis. 2015 Jul 7;14:67. doi: 10.1186/s12944-015-0066-6.
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Diabetologia. 2015 May;58(5):1109-17. doi: 10.1007/s00125-015-3528-5. Epub 2015 Mar 10.