研究主要目的是評估給予高血脂病患Atorvastatin （a HMG-CoA reductase inhibitor）治療對其血液中抗氧化分子及尿液中8-OHdG濃度的影響。到目前為止，Statins類藥物的治療對於血液中抗氧化分子濃度及LDL氧化的影響仍然頗有爭議。因此，本研究針對19位高血脂病患( LDL > 130 mg/dl），給予Atorvastatin/day 10 mg 共5個月，追蹤其血漿中CoQ10、vitamin E和vitamin C、血清中creatine phosphokinase（CPK）、全血中還原態麩胱甘（GSH）和氧化態麩胱甘（GSSG）及尿液中8-OHdＧ濃度的變化。本研究經財團法人彰化基督教醫院人體試驗委員會核准，給予藥物前及療程結束後隔天抽取受試者空腹血液及收取尿液。實驗結果顯示，高血脂病患在服用Atorvastatin後，血清中total cholesterol、LDL cholesterol和triglyceride濃度有顯著下降，雖然血漿中CoQ10及vitamin E明顯降低，但經由total cholesterol、LDL cholesterol和HDL cholesterol分別校正後，CoQ10/LDL-cholesteol 和 vitamin E/LDL-cholesterol的比值是上升的，而CoQ10/HDL-cholesterol 和vatamin E/HDL-cholesterol的比值卻是下降的； 另外，藥物治療對血漿中vitamin C及全血中GSH和GSSG濃度沒有顯著影響。 整體而言， Atorvastatin 為療效佳的降血脂藥物，對於高血脂症的治療及降低心血管疾病的風險具有潛在的益處；同時它對體內抗氧化分子濃度變化並無不良影響。
Abstract
The objective of this study was to evaluate Atorvastatin (a HMG-CoA reductase inhibitor) on blood antioxidants and urinary 8-OHdG levels in hyperlipidemic patients. It is not consistent that statins therapy on the alterations in antioxidant levels and oxidative susceptibility of LDLs. Therefore, the effect of therapeutic dose of Atorvastatin on plasma CoQ10, vitamins E and C, and serum creatine phosphokinase (CPK)， whole blood cell reduced glutathione（GSH）and oxidized glutathione（GSSG）, and urinary 8-OHdG levels were measured in 19 hyperlipidemic subjects (LDL-C >130 mg/dl) before giving 10 mg/day Atorvastatin and 5 months after the treatment. All of the human experimental procedures followed the medical ethical guidelines of Changhua Christian Hospital, Changhua, Taiwan. Blood and urine samples were collected from hyperlipidemic patients after overnight fasting. As expected, total cholesterol, LDL cholesterol and triglyceride levels decreased significantly. Although reduced plasma vitamin E and CoQ10, 10 mg of Atorvastatin treatment is associated with significantly increased CoQ10/LDL-cholestrrol and vitamin E/LDL-cholesterol ratios; However，the CoQ10/HDL-cholesterol and vitamin E/HDL-cholesterol ratios decreased in patients after Atorvastatin treatment; Plasma vitamin C, whole blood GSH and GSSG concentration did not change by the drug treatment. Our results suggest that treatment with Atorvastatin has a potential beneficial effect to decrease the CVD risk in hyperlipidemic patients.
Keywords: Atorvastatin; HMG-CoA reductase inhibitor ; antioxidants; 8-OHdG; hyperlipidemia
