首页> 外文期刊>Journal of atherosclerosis and thrombosis. >Differential Effects of Atorvastatin and Pitavastatin on Inflammation, Insulin Resistance, and the Carotid Intima-Media Thickness in Patients with Dyslipidemia
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Differential Effects of Atorvastatin and Pitavastatin on Inflammation, Insulin Resistance, and the Carotid Intima-Media Thickness in Patients with Dyslipidemia

机译:阿托伐他汀和匹伐他汀对血脂异常患者炎症,胰岛素抵抗和颈动脉内膜中层厚度的影响

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Aims : 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors (statins) have multiple pleiotropic effects, such as anti-inflammatory and vascular endothelium protection, that are independent of their low-density-lipoprotein (LDL) cholesterol lowering effects. However, whether different statins exert diverse effects on inflammation, insulin resistance, and the progression of carotid atherosclerosis [as indicated by the intima-media thickness (CIMT)] in patients with dyslipidemia remains unclear. Methods : A total of 146 patients with hypercholesterolemia without known cardiovascular disease were randomly assigned to receive 5 mg/day of atorvastatin ( n =73) or 1 mg/day of pitavastatin ( n =73). Results : At baseline, age, gender, blood pressure, lipid profiles, and the serum monocyte chemoattractant protein (MCP)-1, homeostasis model assessment of insulin resistance (HOMA-IR) and CIMT values were comparable between the groups. After 12 months of treatment, atorvastatin and pitavastatin equally reduced the LDL cholesterol levels; however, atorvastatin increased the HOMA-IR by +26% and pitavastatin decreased this parameter by -13% ( p <0.001). The MCP-1 values were reduced by -28% in the patients treated with pitavastatin and only -11% in those treated with atorvastatin ( p =0.016). A greater percent decrease in the mean CIMT from baseline was observed in the patients treated with pitavastatin than in those treated with atorvastatin (-4.9% vs. -0.5%, p =0.020). Conclusions : These data indicate that, while these agents significantly and equally reduce the LDL cholesterol levels, atorvastatin and pitavastatin have different effects on inflammation, insulin resistance, and the progression of carotid atherosclerosis in patients with dyslipidemia.
机译:目的:3-羟基-3-甲基戊二酰辅酶A还原酶抑制剂(他汀类药物)具有多种多效作用,例如抗炎和血管内皮保护作用,而与低密度脂蛋白(LDL)胆固醇降低作用无关。然而,在血脂异常患者中,不同的他汀类药物是否对炎症,胰岛素抵抗和颈动脉粥样硬化的进展[由内膜中膜厚度(CIMT)指示]是否发挥不同的作用,目前尚不清楚。方法:总共146名无已知心血管疾病的高胆固醇血症患者被随机分配接受5毫克/天的阿托伐他汀(n = 73)或1毫克/天的匹伐他汀(n = 73)。结果:在基线,年龄,性别,血压,血脂谱和血清单核细胞趋化蛋白(MCP)-1方面,两组间胰岛素抵抗(HOMA-IR)和CIMT值的稳态模型评估具有可比性。治疗12个月后,阿托伐他汀和匹伐他汀同样降低LDL胆固醇水平;但是,阿托伐他汀使HOMA-IR升高+ 26%,匹伐他汀使该参数降低-13%(p <0.001)。匹伐他汀治疗的患者的MCP-1值降低了-28%,阿托伐他汀治疗的患者的MCP-1值仅降低了-11%(p = 0.016)。在匹伐他汀治疗的患者中观察到的平均CIMT相对于基线的降低幅度大于阿托伐他汀治疗的患者(-4.9%对-0.5%,p = 0.020)。结论:这些数据表明,尽管这些药物显着且均等地降低了LDL胆固醇水平,但阿托伐他汀和匹伐他汀对血脂异常患者的炎症,胰岛素抵抗和颈动脉粥样硬化的进展具有不同的作用。

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