Changes of cholesterol absorption and synthesis markers in patients with coronary atherosclerotic heart disease during antilipemic therapy
Wu Wenfeng
Chen Panpan
Nie Shaoping
Wang Luya
Abstract：Objective To observe changes of cholesterol absorption and synthesis markers in patients with coronary atherosclerotic heart disease (CHD) during lipid-lowing therapy with atorvastatin and ezetimibe.Methods Fifty-two patients with CHD diagnosed by coronary angiography from June to September 2016 in Beijing Anzhen Hospital,Capital Medical University were treated with atorvastatin 20 mg/d for 4 weeks.Patients with standard blood lipid level[total cholesterol(TC) and low density lipoprotein cholesterol(LDL-C)] after treatment were allocated to monotherapy group to continue atorvastatin;patients with abnormal blood lipid level were allocated to combined therapy group to take atorvastatin and ezetimibe(10 mg/d) for 4 weeks.Concentrations of cholesterol synthesis markers (lathosterol and desmosterol) and absorption markers (campesterol and sitosterol)were measured before and after 4,8 weeks of treatment by gas chromatography method.Results After 4 weeks of treatment with atorvastatin,levels of TC and LDL-C significantly decreased compared to those before treatment in 52 cases[(3.91 ±0.11) mmol/L vs (4.67 ±0.15) mmol/L,(2.20 ±0.09) mmol/L vs (2.94 ±0.15)mmol/L] (P ＜ 0.05);the standard-reaching rate was 63.5％ (33/52).After 8 weeks of treatment,levels of TC and LDL-C in combined therapy group (19 cases) were significantly lower than those 4 weeks before [(3.69 ± 0.15) mmol/L vs (4.41 ± 0.13) mmol/L,(1.72 ± 0.12) mmol/L vs (2.78 ± 0.14) mmol/L] (P ＜ 0.01);the standard-reaching rate was 63.2％ (12/19).The level of lathosterol in combined therapy group was significantly lower than that in monotherapy group before treatment [(11.0 ± 2.5) mg/L vs (17.2 ± 3.5) mg/L] (P ＜ 0.05).Levels of campesterol,sitosterol and campesterol/TC ratio after 8 weeks of treatment in combined therapy group were significantly lower than those after 4 weeks of treatment [(3.5 ± 0.5) mg/L vs (7.2 ± 1.0) mg/L,(12.4 ± 1.1) mg/L vs (14.6 ± 1.2) mg/L,(2.5 ± 0.3) μg/mg vs (4.3 ± 0.5) μg/mg] (P ＜ 0.05).Conclusion CHD patients with high cholesterol synthesis level can benefit from atorvastatin through lowering cholesterol synthesis;patients with low cholesterol synthesis level should take ezetimibe in combination with atorvastatin to lower cholesterol absorption and blood lipid level.
Keywords：Coronary atherosclerotic heart diseaseAntilipemic therapyCholesterol synthesis and absorption markers
Publication Date：2017-01-01
Online Publishing Date：2026-09-14(First online date of this platform, not the publication date of the document)
Pages：5( 810-814 )