Effects of atorvastatin and vitamin E on lipoproteins and oxidative stress in dialysis patients: a randomised-controlled trial

被引:67
作者
Diepeveen, SHA
Verhoeven, GWHE
Van der Palen, J
Dikkeschei, LD
Van Tits, LJ
Kolsters, G
Offerman, JJG
Bilo, HJG
Stalenhoef, AFH
机构
[1] Isala Clin, Dept Internal Med, Zwolle, Netherlands
[2] Radboud Univ Nijmegen Med Ctr, Dept Nephrol, Nijmegen, Netherlands
[3] Med Spectrum Twente, Dept Epidemiol, Enschede, Netherlands
[4] Isala Clin, Dept Clin Chem, Zwolle, Netherlands
[5] Radboud Univ Nijmegen Med Ctr, Dept Gen Internal Med, Nijmegen, Netherlands
关键词
dialysis; lipoproteins; oxidative stress; randomised-controlled trial; statin; vitamin E;
D O I
10.1111/j.1365-2796.2005.01484.x
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Objectives. The objective of this study was to examine the effects of treatment with atorvastatin, alpha-tocopherol and the combination of both, on lipoproteins and oxidative stress in dialysis patients. Design and setting. This double-blind randomised placebo-controlled trial was performed at the dialysis department of a non-university hospital. Subjects, intervention and measurements. A total of 44 clinically stable, non-diabetic patients on dialysis therapy (23 on haemo- and 21 on peritoneal-dialysis) without manifest cardiovascular disease were included in this study. They were randomised for treatment during a period of 12 weeks with 40 mg atorvastatin + placebo alpha-tocopherol (group 1) once daily, 800 IU alpha-tocopherol + placebo atorvastatin once daily (group 2), 40 mg atorvastatin + 800 IU alpha-tocopherol once daily (group 3), or placebo atorvastatin + placebo alpha-tocopherol once daily (group 4). Assessment of lipid profile and oxidative stress was performed at the start of the study and after 12 weeks of treatment. Results. Treatment with atorvastatin reduced total cholesterol, triglycerides (TG), low-density lipoprotein (LDL) cholesterol, apolipoprotein B (apoB) and levels of oxidised LDL (oxLDL) with 30-43%. It had no influence on LDL oxidisability. Additional supplementation with alpha-tocopherol had no effect on lipid profile and oxLDL levels but decreased in vitro LDL oxidisability. No side-effects were observed. Conclusions. Treatment with atorvastatin is effective in lowering plasma total cholesterol, TG, LDL, apoB and oxLDL in a population of stable dialysis patients and might therefore be an effective tool in improving the poor cardiovascular outcome in these patients. Supplementation of alpha-tocopherol to atorvastatin had beneficial effects on in vitro LDL oxidisability and might therefore be of additional value. Further research on the clinical effects of treatment with atorvastatin in combination with alpha-tocopherol is necessary.
引用
收藏
页码:438 / 445
页数:8
相关论文
共 24 条
  • [11] KLEINVELD HA, 1992, CLIN CHEM, V38, P2066
  • [12] Pro-oxidative effect of α-tocopherol in the oxidation of LDL isolated from co-antioxidant-depleted non-diabetic hemodialysis patients
    Ohkawa, S
    Yoneyama, T
    Shimoi, K
    Takita, T
    Maruyama, Y
    Kumagai, H
    [J]. ATHEROSCLEROSIS, 2004, 176 (02) : 411 - 418
  • [13] Six-year effect of combined vitamin C and E supplementation on atherosclerotic progression -: The Antioxidant Supplementation in Atherosclerosis Prevention (ASAP) study
    Salonen, RM
    Nyyssönen, K
    Kaikkonen, J
    Porkkala-Sarataho, E
    Voutilainen, S
    Rissanen, TH
    Tuomainen, TP
    Valkonen, VP
    Ristonmaa, U
    Lakka, HM
    Vanharanta, M
    Salonen, JT
    Poulsen, HE
    [J]. CIRCULATION, 2003, 107 (07) : 947 - 953
  • [14] Kidney disease as a risk factor for development of cardiovascular disease - A statement from the American Heart Association Councils on kidney in cardiovascular disease, high blood pressure research, clinical cardiology, and epidemiology and prevention
    Sarnak, MJ
    Levey, AS
    Schoolwerth, AC
    Coresh, J
    Culleton, B
    Hamm, LL
    McCullough, PA
    Kasiske, BL
    Kelepouris, E
    Klag, MJ
    Parfrey, P
    Pfeffer, M
    Raij, L
    Spinosa, DJ
    Wilson, PW
    [J]. HYPERTENSION, 2003, 42 (05) : 1050 - 1065
  • [15] HMG-CoA reductase inhibitors are associated with reduced mortality in ESRD patients
    Seliger, SL
    Weiss, NS
    Gillen, DL
    Kestenbaum, B
    Ball, A
    Sherrard, DJ
    Stehman-Breen, CO
    [J]. KIDNEY INTERNATIONAL, 2002, 61 (01) : 297 - 304
  • [16] Shoji T, 1998, J AM SOC NEPHROL, V9, P1277
  • [17] Atherogenic lipoproteins in end-stage renal disease
    Shoji, T
    Ishimura, E
    Inaba, M
    Tabata, T
    Nishizawa, Y
    [J]. AMERICAN JOURNAL OF KIDNEY DISEASES, 2001, 38 (04) : S30 - S33
  • [18] Randomised controlled trial of vitamin E in patients with coronary disease: Cambridge Heart Antioxidant Study (CHAOS)
    Stephens, NG
    Parsons, A
    Schofield, PM
    Kelly, F
    Cheeseman, K
    Mitchinson, MJ
    Brown, MJ
    [J]. LANCET, 1996, 347 (9004) : 781 - 786
  • [19] Valagussa F, 1999, LANCET, V354, P447, DOI 10.1016/S0140-6736(99)07072-5
  • [20] van den Akker JM, 2003, J NEPHROL, V16, P238