Roles of Achieved Levels of Low-Density Lipoprotein Cholesterol and High-Sensitivity C-Reactive Protein on Cardiovascular Outcome in Statin Therapy

The Link between Magnesium Supplements and Statin Medication in Dyslipidemic Patients

Many investigations have discovered a connection between statins and magnesium supplements. On one hand, increasing research suggests that chronic hypomagnesemia may be an important factor in the etiology of some metabolic illnesses, including obesity and overweight, insulin resistance and type 2 diabetes mellitus, hypertension, alterations in lipid metabolism, and low-grade inflammation. Chronic metabolic problems seem to be prevented by a high Mg intake combined with diet and/or supplements. On the other hand, it is known that statins lower the frequency of cardiac events, stroke, and mortality, not by lowering LDL-C, but by the capacity to reduce mevalonate formation. That will enhance endothelial function, inhibit vascular smooth muscle cell proliferation and migration and encourage macrophages to promote plaque stability and regression while reducing inflammation. Taking these factors into consideration, we did an extensive analysis of the relevant literature, comparing the effects of Mg² and statin medications on lipoproteins and, implicitly, on the key enzymes involved in cholesterol metabolism.

The Effect of Statins on C-Reactive Protein in Stroke Patients: A Systematic Review of Clinical Trials

Background

Statins reportedly have anti-inflammatory effects aside from their lipid-lowering impact. We investigated the effects of statin therapy on the level of C-reactive protein (CRP) or highly sensitive CRP (hs-CRP), a liver-derived marker of systemic inflammation, among stroke patients.

Methods

An online search was performed in Scopus, PubMed/MEDLINE, ISI Web of Science, and Google Scholar up to November 2020 to recognize clinical trials investigating the effects of statins on the CRP level in stroke patients.

Results

Overall, nine studies (11 treatment arms) with 1659 participants met the inclusion criteria. Six out of 9 studies (8 out of 11 arms) were categorized as studies with a high-quality methodological approach using the Cochrane Collaboration's tool. Data from 5 treatment arms indicated a significant decrease in CRP concentration, and in one treatment arm, CRP concentration did not suggest any considerable alteration following statin therapy. Moreover, two treatment arms showed a significant reduction in hs-CRP concentration and three treatment arms revealed no significant alteration in hs-CRP concentration following statin therapy. Generally, results were heterogeneous and independent of the type of statin, statin dose, treatment duration, and changes in plasma low-density lipoprotein cholesterol concentration.

Conclusion

The results suggest that statin therapy could reduce and, therefore, could be considered in these patients as potential anti-inflammatory agents.

Metabolic signatures of cholesterol biosynthesis and absorption in patients with coronary artery disease

Due to the biochemical importance of cholesterol homeostasis in cardiovascular disease (CVD), this study was aimed to identify metabolic signatures of serum sterols according to atherosclerotic CVD severity. Biogically active free cholesterol and its 11 analogues in serum samples obtained from subjects who underwent cardiovascular intervention were quantitatively evaluated by gas chromatography-mass spectrometry (GCMS). Study groups were divided by 29 patients with stable angina (SA), 35 patients with acute coronary syndrome (ACS), and 41 controls. In all subjects, serum levels of cholesterol and its upstream precursors of 7-dehydrocholesterol, lathosterol, and lanosterol were closely associated with CVD risk factors, such as total cholesterol, low-density lipoprotein cholesterol (LDL-C), and LDL-C/high-density lipoprotein cholesterol (HDL-C) ratio (r = 0.407 ∼ 0.684, P < 0.03 for all). Metabolic ratios of lathosterol/cholesterol (control = 55.75 ± 34.34, SA = 51.04 ± 34.93, ACS = 36.52 ± 22.00; P < 0.03) and lanosterol/cholesterol (control = 12.27 ± 7.43, SA = 10.97 ± 9.13, ACS = 8.01 ± 5.82; P < 0.03), were remarkably decreased. Both metabolic ratios and individual concentrations of lathosterol and lanosterol were also decreased in subjects with statin treatment than those in the control group without statin treatment (P < 0.05 for all), whereas three metabolic ratios of dietary sterols (sitosterol, campesterol, and stigmasterol) to free cholesterol were increased after statin therapy (P < 0.05 for all) in both SA and ACS groups. The present metabolic signatures suggest that both lathosterol/cholesterol and lanosterol/cholesterol ratios corresponding to cholesterol biosynthesis may reflect statin response. Individual dietary sterols to cholesterol ratios resulted in higher intestinal cholesterol absorption after statin therapy.

Metabolic Changes in Hyperlipidemic Rats After The Administration of Xuezhikang

Background:

Xuezhikang capsule, which contains cholesterol synthase inhibitors and a large number of natural statins, is put in the clinical application of lipid-lowering and so on. However, the specific use of dose, lipid-lowering effect and the relationship between metabolites are to be further studied.

Introduction:

Metabonomics is the study of the relationship between the change of quantity and physiological changes from metabolites. At present metabolomics has been widely used in drug development and testing. In this study, we developed a metabolomic method based on gas chromatography-mass spectrometry (GC-MS) to find out hyperlipemia-related substances, and study the lipid-lowering mechanism of Xuezhikang.

Method:

Fifty SD rats (220 ± 20 g) were given high-fat diet. After four-weeks modeling, they were randomly divided into semi-control group, high fat group, simvastatin intervention group and Xuezhikang intervention group (0.23, 0.69, 1.15 mg/kg, low, medium, high), each dosage in eight rats. The control group (rest eight rats) were given normal diet, and no specific treatment. The rats were sacrificed at the end of the experiment.

Result:

The biochemical and body weight indexes of the normal control group and the high fat group were significantly different (P <0.05), which indicated that the model of hyperlipidemia was established success. There was significant difference (P <0.05) between Xuezhikang intervention group and high fat control group (P <0.05), and hyperlipemia metabolomics related markers, oxalic acid, butyric acid, mannitol, glucose, glucuronic acid were found. Glucuronic acid and non-binding bilirubin combined with bilirubin, combined with some of the liver harmful substances, play a detoxification effect.

Conclusion:

The results of metabonomics showed that the high-fat group and the control group have significant differences. Mannose, glucose content is relatively stable, lipid metabolism in high-fat group stearic acid, palmitic acid levels decreased, suggesting that high-fat diet disorders rat body lipid metabolism. It is worth mentioning that the experimental evaluation of rats, such as biochemical indicators and pathological results are prompted to model success, Xuezhikang intervention effect is more significant, consistent with the expected.

Conclusion:

The results of metabonomics showed that the high fat group and the control group were significant difference. Mannose, glucose content is relatively stable, lipid metabolism in high-fat group stearic acid, palmitic acid levels decreased, suggesting that high-fat diet disorders rat body lipid metabolism. It is worth mentioning that the experimental evaluation of rats such as biochemical indicators and pathological results are prompted to model success, Xuezhikang intervention effect is more significant, consistent with the expected.