title: Statins and lipid metabolism: an update.
abstract: OBJECTIVE
  The reduction in cardiovascular disease risk by statins is well established. This risk reduction has mostly been attributed to decreases in plasma LDL cholesterol and other pleiotropic effects of statins. Emerging evidence indicates that statins exert multiple effects on lipoprotein metabolism, including chylomicrons and HDLs.
  
  
  RESULTS
  Kinetic and in-vitro studies have documented that the effects of statins on the metabolism of different lipoproteins are for the most part the direct consequence of cholesterol biosynthesis inhibition and the subsequent change in transcription factors and cell signaling, regulating different aspects of lipoprotein metabolism. Differences in pharmacokinetics and pharmacodynamics among statins lead to diverse biological outcomes.
  
  
  CONCLUSIONS
  The current review summarizes recent experimental evidence highlighting the different effects of statins on cellular pathways regulating gene expression. Understanding the basic mechanisms by which different statins regulate lipoprotein metabolism will lead to improved strategies for the prevention and treatment of specific lipoprotein disorders.
authors.affiliation: Lipid Metabolism Laboratory, Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, Massachusetts 02111, USA. stefania.lamon-fava@tufts.edu
authors.forename: Stefania
authors.initials: S
authors.lastname: Lamon-Fava
mesh_terms: D064286:ATP Binding Cassette Transporter 1 / Q000235:genetics / Q000378:metabolism; D000818:Animals; D002318:Cardiovascular Diseases / Q000097:blood / Q000188:drug therapy* / Q000503:physiopathology; D008076:Cholesterol, HDL / Q000819:agonists / Q000097:blood; D008078:Cholesterol, LDL / Q000037:antagonists & inhibitors / Q000097:blood; D002914:Chylomicrons / Q000097:blood; D005786:Gene Expression Regulation; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000493:pharmacokinetics / Q000494:pharmacology*; D025782:Hydroxymethylglutaryl-CoA-Reductases, NADP-dependent / Q000235:genetics / Q000378:metabolism*; D050356:Lipid Metabolism / Q000187:drug effects*; D000071449:Proprotein Convertase 9; D043484:Proprotein Convertases / Q000235:genetics / Q000378:metabolism; D012697:Serine Endopeptidases / Q000235:genetics / Q000378:metabolism; D015398:Signal Transduction; D014157:Transcription Factors / Q000819:agonists / Q000037:antagonists & inhibitors / Q000235:genetics*
chemical_list: C577836:ABCA1 protein, human; D064286:ATP Binding Cassette Transporter 1; D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D002914:Chylomicrons; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D014157:Transcription Factors; D025782:Hydroxymethylglutaryl-CoA-Reductases, NADP-dependent; C472125:PCSK9 protein, human; D000071449:Proprotein Convertase 9; D043484:Proprotein Convertases; D012697:Serine Endopeptidases