Effects of atorvastatin on low-density lipoprotein cholesterol phenotype and C-reactive protein levels in patients undergoing long-term dialysis.
OBJECTIVE
To determine the effects of atorvastatin on low-density lipoprotein cholesterol (LDL) particle size and C-reactive protein (CRP) concentrations in patients undergoing long-term hemodialysis. Another objective was to compare the effects of atorvastatin on lipoprotein profiles as determined by direct versus indirect assessment of lipoprotein composition.


METHODS
Randomized, parallel-group substudy.


METHODS
Two university-affiliated outpatient hemodialysis centers.


METHODS
Nineteen patients with LDL levels above 100 mg/dl and with at least two cardiovascular risk factors.


METHODS
Patients were randomized in a 1:1 ratio to atorvastatin 10 mg/day or no treatment (control) for 20 weeks.


RESULTS
We compared the differences between LDL particle size and CRP levels at baseline and 20 weeks in the atorvastatin versus control groups. Baseline demographic characteristics were similar between the two groups. Atorvastatin therapy was associated with no change in mean LDL particle size (p=0.23) and with a 90% decrease in mean CRP level (p=0.52). When evaluated by standard chemical analysis, atorvastatin therapy reduced total cholesterol levels by 29% (p=0.025) and resulted in nonsignificant reductions in LDL, high-density lipoprotein cholesterol, and triglyceride levels. Treatment with atorvastatin was not associated with significant changes in lipoprotein profile as determined by nuclear magnetic resonance (NMR) spectroscopy.


CONCLUSIONS
Treatment with atorvastatin did not affect LDL particle size but was associated with a sizable, yet nonsignificant, reduction in CRP concentrations. The drug had variable effects on lipoprotein concentrations as determined by chemical and NMR analytical methods. A larger study is necessary to provide definitive information on the effects of atorvastatin on LDL phenotype and CRP in patients with kidney disease.
Dornbrook-Lavender
Kimberly A
KA
Department of Pharmacotherapy, School of Pharmacy, University of North Carolina, Chapel Hill, North Carolina, USA.
Joy
Melanie S
MS
Denu-Ciocca
Cynthia J
CJ
Chin
Hyunsook
H
Hogan
Susan L
SL
Pieper
John A
JA
D000368:Aged; D000924:Anticholesteremic Agents / Q000494:pharmacology*; D000069059:Atorvastatin; D002097:C-Reactive Protein / Q000187:drug effects / Q000378:metabolism*; D002784:Cholesterol / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood*; D002908:Chronic Disease; D005260:Female; D006538:Heptanoic Acids / Q000494:pharmacology*; D006801:Humans; D006937:Hypercholesterolemia / Q000150:complications / Q000188:drug therapy; D007676:Kidney Failure, Chronic / Q000150:complications / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D010316:Particle Size; D010641:Phenotype; D010865:Pilot Projects; D011758:Pyrroles / Q000494:pharmacology*; D006435:Renal Dialysis; D012307:Risk Factors; D014280:Triglycerides / Q000097:blood
D000924:Anticholesteremic Agents; D008078:Cholesterol, LDL; D006538:Heptanoic Acids; D011758:Pyrroles; D014280:Triglycerides; D002097:C-Reactive Protein; D002784:Cholesterol; D000069059:Atorvastatin