小剂量阿托伐他汀对代谢综合征患者血清炎症因子和胰岛素抵抗的影响

目的观察小剂量阿托伐他汀对代谢综合征(MS)患者血清超敏C反应蛋白(hsCRP)、肿瘤坏死因子α(TNF-α)和胰岛素抵抗(IR)的影响。方法选取MS患者60例,随机分为MS对照组和治疗组,每组30例。对照组给予常规治疗;治疗组加用阿托伐他汀10mg/d,共4周。30例健康体检者作为正常对照组。血清hsCRP和TNF-α分别用免疫比浊法和酶联免疫吸附法测定。结果①MS患者治疗前血清hsCRP、TNF-α、胰岛素抵抗指数(HOMA-IR)和血总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)水平均高于正常对照组(P均<0.05),而高密度脂蛋白胆固醇(HDL-C)低于正常对照组(P<0.05);②MS治疗组4周后,与治疗前相比血清hsCRP、TNF-α水平、血TC、TG、LDL-C及HOMA-IR均明显降低(P<0.05或<0.01),HDL-C、BMI与治疗前比较无显著性差异(P>0.05)。而对照组各指标治疗前后比较无显著性差异(P>0.05);③MS治疗组4周后血清hsCRP、TNF-α水平的下降幅度与血TC、LDL-C的下降幅度无相关性。结论短期应用小剂量阿托伐他汀即可降低MS患者血脂、HOMA-IR和血清hsCRP、TNF-α水平,有改善IR、抗炎作用,且独立于调脂之外。

Effects of low-dose atorvastatin on insulin resistance and serum inflammatory factors in patients with metabolic syndrome

Objective To observe the effects of low-dose atorvastatin on insulin resistance(IR) as well as the levels of serum high sensitive C-reactive protein(hsCRP) and tumor necrosis factor-α(TNF-α) in patients with metabolic syndrome(MS).Methods Totally 60 inpatients with MS were randomly divided into the treatment group(n=30) and the control group(n=30).Patients in the control group received conventional therapy while those in the treatment group were administered with atorvastatin(10mg/d) in addition to the conventional therapy.The treatment lasted 4 weeks.The levels of serum hsCRP and TNF-α of the two groups of patients were measured by immunoturbidimetry and enzyme linked immunosorbent assay,respectively.The IR index was calculated by a balanced pattern of HOMA.Results ① Levels of serum hsCRP,TNF-α,TC,TG,LDL-C and HOMA-IR were significantly higher in the MS group than in the normal subjects(P<0.05 or P<0.01),whereas HDL-C was lower(P<0.05).② Levels of serum hsCRP,TNF-α,TC,TG,LDL-C and HOMA-IR decreased significantly in the MS patients after atorvastatin treatment(P<0.05 or P<0.01).However,no significant improvement was found in the control patients with MS(P>0.05).③ In the treatment group,the decrease of serum hsCRP and TNF-α levels did not parallel with the changes of plasma TC and LDL-C.Conclusion Short-term administration of atorvastatin at low dose can not only decrease the levels of blood lipids,serum hsCRP and TNF-α,but also improve IR and act as an anti-inflammatory agent in MS.