title: Influence of 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitor, pravastatin, on corticosteroid metabolism in patients with heterozygous familial hypercholesterolemia.
abstract: The present study examined whether hypolipidemic therapy with a potent 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitor, pravastatin, influences corticosteroid metabolism in patients with heterozygous familial hypercholesterolemia (FH). Urinary excretion of tetrahydrocortisone, tetrahydrocortisol, 6 beta-hydroxycortisol and free cortisol were determined in 22 patients with heterozygous FH before and after pravastatin administration (10 mg/day for 2 months). Pravastatin induced a statistically significant decrease in serum total cholesterol in patients with heterozygous FH from 6.9 +/- 0.1 to 5.9 +/- 0.1 mmol/l (p less than 0.05). No significant changes were seen in the urinary tetrahydrocortisone, tetrahydrocortisol and free cortisol levels before and after pravastatin therapy. Urinary excretion of 6 beta-hydroxycortisol was significantly (p less than 0.05) increased after pravastatin administration. These results suggest that the hypolipidemic effect of pravastatin in patients with heterozygous FH does not influence the corticosteroid metabolism. The increase in urinary 6 beta-hydroxycortisol may be caused by pravastatin-induced hepatic microsomal 6 beta-hydroxylase induction.
authors.affiliation: Second Department of Internal Medicine, School of Medicine, Kanazawa, Japan.
authors.forename: Y
authors.initials: Y
authors.lastname: Takeda
authors.forename: I
authors.initials: I
authors.lastname: Miyamori
authors.forename: U
authors.initials: U
authors.lastname: Karayalçin
authors.forename: R
authors.initials: R
authors.lastname: Takeda
mesh_terms: D000305:Adrenal Cortex Hormones / Q000652:urine*; D002784:Cholesterol / Q000097:blood; D005260:Female; D006579:Heterozygote; D006801:Humans; D006854:Hydrocortisone / Q000031:analogs & derivatives / Q000652:urine; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D006938:Hyperlipoproteinemia Type II / Q000188:drug therapy* / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D017035:Pravastatin / Q000009:adverse effects* / Q000627:therapeutic use; D013760:Tetrahydrocortisol / Q000652:urine; D013761:Tetrahydrocortisone / Q000652:urine
chemical_list: D000305:Adrenal Cortex Hormones; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; C001380:6 beta-hydroxycortisol; D013761:Tetrahydrocortisone; D013760:Tetrahydrocortisol; D002784:Cholesterol; D017035:Pravastatin; D006854:Hydrocortisone