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首页> 外文期刊>The Journal of Clinical Pharmacology: Official Journal of the American College of Clinical Pharmacology >Comparative effects of atorvastatin, simvastatin, and fenofibrate on serum homocysteine levels in patients with primary hyperlipidemia.
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Comparative effects of atorvastatin, simvastatin, and fenofibrate on serum homocysteine levels in patients with primary hyperlipidemia.

机译：阿托伐他汀，辛伐他汀和非诺贝特对原发性高脂血症患者血清高半胱氨酸水平的比较作用。

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Hyperhomocysteinemia is regarded as an independent risk factor for cardiovascular disease. Lipid-lowering agents, such as fibrates, can modify homocysteine levels. However, less is known about the effect of statin therapy on homocysteine. The authors compared the effects of atorvastatin (40 mg/day), simvastatin (40 mg/day), and micronized fenofibrate (200 mg/day) on the serum concentrations of total homocysteine, vitamin B12, and folic acid in patients with primary hyperlipidemia. A total of 128 patients with primary hyperlipidemia (total cholesterol > 240 mg/dL and triglycerides < 350 mg/dL) were assigned to atorvastatin, simvastatin, or fenofibrate. Serum lipid and metabolic parameters were measured at baseline and at 6 and 12 weeks of treatment. Homocysteine correlated positively with serum creatinine and uric acid levels and inversely with serum folic acid levels. All treatment modalities reduced total, low-density lipoprotein (LDL) cholesterol, and triglyceride concentrations. High-density lipoprotein (HDL) cholesterol levels significantly increased only in the fenofibrate-treated patients (47.9 +/- 12.5 vs. 50.7 +/- 12.6 vs. 51.2 +/- 12.8 mg/dL, p < 0.01). Atorvastatin and fenofibrate treatment resulted in a significant reduction of serum uric acid levels (5.3 +/- 1.6 vs. 4.9 +/- 1.4 vs. 4.8 +/- 1.4 mg/dL, p < 0.0001 for atorvastatin; 5.6 +/- 1.6 vs. 4.3 +/- 1.4 vs. 4.4 +/- 1.4 mg/dL, p < 0.0001 for fenofibrate). Homocysteine levels were significantly increased only by fenofibrate (10.3 +/- 3.3 vs. 14.1 +/- 3.8 vs. 14.2 +/- 3.6 microU/L, p < 0.001) but did not change from baseline following statin treatment. Neither statins nor fenofibrate had any effect on serum vitamin B12 and folic acid levels. In contrast to fenofibrate, therapeutic dosages of atorvastatin and simvastatin have a neutral effect on serum homocysteine levels, which is in favor of their cardioprotective
机译：高同型半胱氨酸血症被认为是心血管疾病的独立危险因素。降血脂药，例如贝特类药物，可以改变高半胱氨酸水平。然而，关于他汀类药物治疗对同型半胱氨酸的影响了解较少。作者比较了阿托伐他汀（40 mg /天），辛伐他汀（40 mg /天）和微粉非诺贝特（200 mg /天）对原发性高脂血症患者血清总同型半胱氨酸，维生素B12和叶酸的影响。总共128例原发性高脂血症患者（总胆固醇> 240 mg / dL，甘油三酸酯<350 mg / dL）被分配为阿托伐他汀，辛伐他汀或非诺贝特。在基线以及治疗的第6周和第12周测量血清脂质和代谢参数。同型半胱氨酸与血清肌酐和尿酸水平呈正相关，与血清叶酸水平呈负相关。所有治疗方式均降低了总的低密度脂蛋白（LDL）胆固醇和甘油三酸酯的浓度。高密度脂蛋白（HDL）胆固醇水平仅在接受非诺贝特治疗的患者中显着增加（47.9 +/- 12.5 vs. 50.7 +/- 12.6 vs. 51.2 +/- 12.8 mg / dL，p <0.01）。阿托伐他汀和非诺贝特治疗导致血清尿酸水平显着降低（5.3 +/- 1.6 vs. 4.9 +/- 1.4 vs. 4.8 +/- 1.4 mg / dL，阿托伐他汀p <0.0001; 5.6 +/- 1.6 vs. 4.3 +/- 1.4与4.4 +/- 1.4 mg / dL，非诺贝特p <0.0001）。同型半胱氨酸水平仅通过非诺贝特显着增加（10.3 +/- 3.3 vs. 14.1 +/- 3.8 vs. 14.2 +/- 3.6 microU / L，p <0.001），但他汀类药物治疗后与基线相比没有变化。他汀类药物和非诺贝特均对血清维生素B12和叶酸水平没有任何影响。与非诺贝特相比，阿托伐他汀和辛伐他汀的治疗剂量对血清高半胱氨酸水平具有中性作用，有利于它们的心脏保护作用

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