普伐他汀对血脂异常患者血清脂联素的影响

The effect of pravastatin on serum levels of adiponectin in patients with dyslipidaemia

目的:探讨血脂异常患者血清中脂联素、超敏C反应蛋白(hs-CRP)水平及药物干预后其与血脂变化的关系。方法:收集21名正常对照者的血清标本及19例血脂异常患者治疗前及3个月后的血清标本,分别检测其血清脂联素、hs-CRP、总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)浓度;分析脂联素、hs-CRP与血脂浓度间的相关性。结果:治疗前,血脂异常患者血脂和hs-CRP较正常对照组高(P<0.02),脂联素较对照组降低[(5.3±1.6)mg/L比(13.8±2.4)mg/L,P<0.001)]。血脂异常者治疗3个月后,血脂及hs-CRP较治疗前明显下降[hs-CRP治疗后比治疗前:(2.34±1.02)mg/L比(3.24±1.33)mg/L,P<0.05)],同时其脂联素显著升高[(5.3±1.6)mg/L比(8.6±3.0)mg/L,P<0.01)];脂联素与治疗前后HDL-C变化量呈正相关(r=0.48,P<0.01),而hs-CRP与治疗前后HDL-C的变化量成负相关(r=-0.23,P<0.01)。血脂异常组脂联素与hs-CRP呈负相关(r=-0.34,P<0.02)。结论:成人血脂异常患者,其血清抗炎因子脂联素与炎症因子hs-CRP已存在失平衡,而普伐他汀不仅具调脂作用,而且能提高血清脂联素并降低hs-CRP浓度。

Objective To investigate the treatment effects of pravastatin on serum adiponectin and high-sensitivity C-reactive protein （hs-CRP） in patients with dyslipidaemia. Methods Nineteen patients with dyslipidaemia and 21 healthy controls were enrolled in this study. Serum adiponectin, immunoreactive insulin levels, body mass index（BMI）, waist circumference, blood pressure and lipids were determined before and after treatment of pravastatin. Relationship of serum levers of adiponecin and hs-CRP with blood lipid were observed. Results Compared to the controls before the treatment, the patients had higher levels of blood lipid （P〈0.02）, and lower level of adiponectin （P〈0.001）. After treatment of pravastatin for a 3-month in the patients, there was a significant increase in serum adiponectin level [（5.3±1.6） mg/L vs （8.6±3.0） mg/L, P〈0.01], significant decrease in total cholesterol, low density lipoprotein-cholesterol （LDL-C） （P=0.01 and P=0.05, respectively） and serum hs-CRP levels（P〈0.05） and increase in high-density lipoprotein cholesterol （HDL-C） levels （P〈0.01）. The adiponectin concentration was significantly positively correlated with changes in HDL-C （r=0.48; P〈0.01） and the hs-CRP concentration was significantly negatively correlated with changes in HDL-C （r=-0.23; P〈0.01）. In the patients, the adiponectin concentration was significantly negatively correlated with the hs-CRP concentrations（r=-0.34; P〈0.02）. Conclusions Pravastatin could improve serum adiponectin levels and decrease hs-CRP level, despiting its beneficial effects on lipid levels.