A Study On Correlation Between Cholesterol Synthesis Absorption Levels And Statin Efficacy

Objective:The study measured cholesterol markers(cholesterol synthesis, absorption markers)and lipid levels before and after taking atorvastatin, analyzed the correlation between baseline cholesterol metabolism markers and changes of blood lipids level after atorvastatin treatment, than providing guidance for rational selecting lipid-lowering drugs in early phase.Methods:1.We collected 200 subjects of Chinese Han in this study, who need statin therapy according to “Chinese guidelines on preyention and treatment of dyslipidmia in adults”in2007。We determined blood lipids and cholesterol synthesis, absorption markers before and after take 20 mg atorvastatin every night for a month.Analyzed the correlation between baseline cholesterol synthesis absorption levels and the changes of blood lipids after statin treatment.2.Blood lipids :Total cholesterol(TC)、Low density lipoprotein cholesterol(LDL-C)、High density lipoprotein cholesterol(HDL-C)、Triglyceride(TG); cholesterol synthetic markers:Squalene/TC、Desmosterol/TC、Lathosterol/TC;cholesterol absorption markers include:Sitosterol/TC、Stigmasterol/TC、Campesterol/TC.3.According to synthetic markers Lathosterol/TC Tierce layered boundary value were the research object divided into low synthesis group( < 194) 、 medium synthesis(194-361), high synthetic group(> 361); according to the absorption markers Stigmasterol/TC Tierce layered boundary value were the research object divided into low absorption group(<45.4) 、 medium absorption(45.4-89.5), high absorption group( >89.5).Result:1.This study selected 200 cases of the research object, including male 110, female 90.whose average age were 55.3 ± 9.0 years,average BMI were 25.8 ± 3.0 kg/m2, average TC were 6.76 ±2.6 mmol/L and LDL-C were 3.8± 0.9 mmol/L.Baseline cholesterol metabolism markers and lipids didn’t found gender differences.2.The difference of population percentage between groups with different synthesis/absorption ability was existed in same LDL- C levels.There was a negative correlation between baseline cholesterol synthesis markers and absorption markers:Lathosterol/TC with Stigmasterol/TC(r=-0.208,p<0.01)、Squalene/TC with Sitosterol/TC(r=-0.380,p<0.01).3.After 1 month of Atorvastatin treatment, TC, TG, LDL- C were reduced(all of P< 0.01), synthesis markers Lathosterol/TC and absorption markers Stigmasterol/TC(all of P < 0.05) were also reduced.4.Only 30.2% subjects with Lathosterol/TC decreased in baseline low synthesis groups,no subjects was decreased significantly.But the percentage of no reduction was as high as 69.8%. On the contrary,subjects of reduction and no reduction were 81.4% and19.6% in group of high synthesis,and 39.5% subjects were reduced obviously.5.After atorvastatin treatment,in three groups of Low, medium and high synthesis,the reduction of lipids were gradually increased, especially △ TC %(P = 0.018) and △LDL-C % significant most(P = 0.016). In three groups of Low,moderate and high absorption,the reduction of lipids were gradually decreased, especially △LDL- C is the most significant(P = 0.010).There exsist correlation between baseline cholesterol synthesis absorption markers and the changes of blood lipids after statin therapy :synthesis marker Squalene/TC with △LDL-C%(r=-0.236,p<0.01)and absorption marker Stigmasterol/TC With △TC%( r=-0.185,p<0.01) and △LDL-C%(r=-0.187,p<0.01) correlated negativeiy,synthesis marker Lathosterol/TC with △TC%(r= 0.182,p<0.01)correlated positively.Conclusion:1.Among Chinese who need statin therapy,cholesterol synthesis and absorption regulates by negative feedback mechanism to maintain blood lipid levels in the body.2.There are obviously differences between ability of synthesis and absorption in individuals with same lipid levels,this difference is the base of statins lipid-lowering efficacy differences.3.Baseline levels of cholesterol synthesis is higher, the stronger the statin inhibition to its, statin efficacy is better, wheras the higher the absorption, the worse statin efficacy.