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【medical-news】他汀类药物增加HDL-C 的作用显示出临床获益

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Increasing HDL-C via statin therapy shows clinical benefit

7 February 2007

Increases in high-density lipoprotein cholesterol (HDL-C) levels during statin therapy are associated with regression of coronary atherosclerosis, a review of four clinical trials has confirmed.

The common consensus is that lowering low-density lipoprotein cholesterol (LDL-C) levels prevents atherosclerotic cardiovascular disease.

But to date, increases in HDL-C observed during statin therapy have not been directly linked to any beneficial clinical outcome.

Refuting this, Stephen Nicholls (Cleveland Clinic, Ohio, USA) and colleagues say that their findings "provide evidence to support the atherosclerotic properties of HDL-C and therapeutic interventions that increase its levels."

They add, however, that "it remains to be determined whether the atherosclerotic regression associated with changes in lipid levels during this study will translate to meaningful reductions in clinical events."

For their study, the team combined data from four prospective randomized trials, performed between 1999 and 2005, in which 1455 patients with coronary disease underwent serial intravascular ultrasonography while receiving 18–24 months of statin therapy.

The patients were aged an average of 57.6 years and their average body mass index was 30 kg/m2.

During statin therapy, mean LDL-C levels decreased by 23.5%, from 124.0 to 87.5 mg/dl, while mean HDL-C levels increased by 7.5%, from 42.5 to 45.1 mg/dl.

This was accompanied by a mean 5% decrease in total atheroma volume, of 2.4 mm3.

Multivariate analysis revealed that the drop in LDL-C and increase in HDL-C both independently predicted atheroma regression.

"These findings suggest that the increase in HDL-C that occurs during statin therapy is clinically relevant when combined with intensive lowering of LDL-C and should be considered in the selection of therapy and subsequent management of patients with coronary artery disease," say the authors.

They add: "If new therapies can produce increases in functional HDL-C much larger than observed in the current study, they may have the potential to substantially reduce disease burden."

Writing in the Journal of the American Medical Association, they conclude: "It will be important to further elucidate the effect that statins have on both HDL-C and the functional properties of the HDL particle in relation to atheroma progression."

JAMA 2007; 297: 499-508

http://www.incirculation.net/NewsItem/Increasing-HDLC-via-statin-therapy-shows-clinical-.aspx

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2007-02-08 22:58 浏览 : 1063 回复 : 2

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• （原创）血钠183mmol/L的老年人急救处理？

gjb913

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本人已认领该文编译，48小时后若未提交译文，请其他战友自由认领.

2007-02-08 23:24

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• 浙一咋了？？爆炸了？？？

gjb913

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Increasing HDL-C via statin therapy shows clinical benefit
他汀类药物增加HDL-C 的作用显示出临床获益
7 February 2007
2007年2月7号

Increases in high-density lipoprotein cholesterol (HDL-C) levels during statin therapy are associated with regression of coronary atherosclerosis, a review of four clinical trials has confirmed.
对四组临床试验的总结研究显示，他汀类药物治疗所致高密度脂蛋白胆固醇（HDL-C)水平增加可改善冠状动脉粥样硬化。

The common consensus is that lowering low-density lipoprotein cholesterol (LDL-C) levels prevents atherosclerotic cardiovascular disease.
一般而言，降低低密度脂蛋白胆固醇（LDL-C) 水平可预防动脉粥样硬化性心血管疾病。

But to date, increases in HDL-C observed during statin therapy have not been directly linked to any beneficial clinical outcome.
但到目前为止，他汀类药物增加HDL-C作用并没有直接表现出任何有益的临床效果。

Refuting this, Stephen Nicholls (Cleveland Clinic, Ohio, USA) and colleagues say that their findings "provide evidence to support the atherosclerotic properties of HDL-C and therapeutic interventions that increase its levels."
与此相反的是，美国俄亥俄州克利夫兰医院的Stephen Nicholls和同事们声称他们的研究证明了HDL-C与动脉粥样硬化相关的特性，以及他汀类药物治疗可增加HDL-C的水平。

They add, however, that "it remains to be determined whether the atherosclerotic regression associated with changes in lipid

levels during this study will translate to meaningful reductions in clinical events."
尽管如此，他们又补充说：“我们仍需要探讨在此次研究中脂类水平的改变所致动脉粥样硬化的改善是否对实际的临床应用有参考价值。”

For their study, the team combined data from four prospective randomized trials, performed between 1999 and 2005, in which 1455 patients with coronary disease underwent serial intravascular ultrasonography while receiving 18–24 months of statin therapy.
在他们的实验中，研究小组综合研究了从1999年至2005年的四组随机有效数据，里面包含了1455名冠心病患者在服用他汀类药物18至24个月后所进行的一系列血管超声成像检测数据。

The patients were aged an average of 57.6 years and their average body mass index was 30 kg/m2.
这些患者平均年龄为57.6岁，平均体重指数为30Kg/m2。

During statin therapy, mean LDL-C levels decreased by 23.5%, from 124.0 to 87.5 mg/dl, while mean HDL-C levels increased by 7.5%, from 42.5 to 45.1 mg/dl.
在使用他汀类药物治疗中，LDL-C平均水平从124.0下降至87.5mg/dl，降低了23.5%，而HDL-C平均水平则从42.5上升至45.1mg/dl,增加了7.5%。

This was accompanied by a mean 5% decrease in total atheroma volume, of 2.4 mm3.
同时还伴随有动脉粥样体积的显著缩小，平均减小了5%，约为2.4mm3。

Multivariate analysis revealed that the drop in LDL-C and increase in HDL-C both independently predicted atheroma regression.
多变量分析显示LDL-C水平的降低以及HDL-C水平的增加各自都能改善动脉粥样硬化。

"These findings suggest that the increase in HDL-C that occurs during statin therapy is clinically relevant when combined with intensive lowering of LDL-C and should be considered in the selection of therapy and subsequent management of patients with coronary artery disease," say the authors.
“研究结果显示，当综合考虑LDL-C水平的显著降低，他汀类药物所致HDL-C水平的增加可表现出一定的临床效果，因此应在冠心病患者治疗方案的选择上及随后的治疗中给予考虑。”研究者总结道。

They add: "If new therapies can produce increases in functional HDL-C much larger than observed in the current study, they may have the potential to substantially reduce disease burden."
研究者还认为：“如果新的疗法能使HDL—C功能性增加显著大于目前研究下的水平，或许就能够将此应用于临床实际。”

Writing in the Journal of the American Medical Association, they conclude: "It will be important to further elucidate the effect that statins have on both HDL-C and the functional properties of the HDL particle in relation to atheroma progression."
在《美国医学协会》杂志上的论文中，研究者总结认为：“进一步深入阐明他汀类药物对HDL-C的影响以及与此相关的HDL-C缓解动脉粥样硬化的功能特性的作用机理将是非常必要的。”
JAMA 2007; 297: 499-508

http://www.incirculation.net/NewsItem/Increasing-HDLC-via-statin-therapy-shows-clinical-.aspx

编译：

他汀类药物增加HDL-C 的作用显示出临床获益

对四组临床试验的总结研究显示，他汀类药物治疗所致高密度脂蛋白胆固醇（HDL-C)水平增加可改善冠状动脉粥样硬化。一般而言，降低低密度脂蛋白胆固醇（LDL-C) 水平可预防动脉粥样硬化性心血管疾病。但到目前为止，他汀类药物增加HDL-C作用并没有直接表现出任何有益的临床效果。与此相反的是，美国俄亥俄州克利夫兰医院的Stephen Nicholls和同事们声称他们的研究证明了HDL-C与动脉粥样硬化相关的特性，以及他汀类药物治疗可增加HDL-C的水平。尽管如此，他们又补充说：“我们仍需要探讨在此次研究中脂类水平的改变所致动脉粥样硬化的改善是否对实际的临床应用有参考价值。”在他们的实验中，研究小组综合研究了从1999年至2005年的四组随机有效数据，里面包含了1455名冠心病患者在服用他汀类药物18至24个月后所进行的一系列血管超声成像检测数据。这些患者平均年龄为57.6岁，平均体重指数为30Kg/m2。在使用他汀类药物治疗中，LDL-C平均水平从124.0下降至87.5mg/dl，降低了23.5%，而HDL-C平均水平则从42.5上升至45.1mg/dl,增加了7.5%。同时还伴随有动脉粥样体积的显著缩小，平均减小了5%，约为2.4mm3。多变量分析显示LDL-C水平的降低以及HDL-C水平的增加各自都能改善动脉粥样硬化。“研究结果显示，当综合考虑LDL-C水平的显著降低，他汀类药物所致HDL-C水平的增加可表现出一定的临床效果，因此应在冠心病患者治疗方案的选择上及随后的治疗中给予考虑。”研究者总结道。研究者还认为：“如果新的疗法能使HDL—C功能性增加显著大于目前研究下的水平，或许就能够将此应用于临床实际。”在《美国医学协会》杂志上的论文中，研究者总结认为：“进一步深入阐明他汀类药物对HDL-C的影响以及与此相关的HDL-C缓解动脉粥样硬化的功能特性的作用机理将是非常必要的。”

2007-02-10 00:43

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gjb913 编辑于 2007-02-10 00:45

• # 妇儿联动 # 启动期，作为妇产科/儿科医生，你有哪些问题，想请教对方？

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