title: Association of high-density lipoprotein cholesterol with improvement of endothelial dysfunction recovery in renovascular disease.
abstract: BACKGROUND
  This study was aimed to assess the ratio of total cholesterol (TC) to high-density density lipoprotein cholesterol (HDLC) and plasma nitrate levels in patients with ischemic nephropathy receiving statins and niacin extended release (NER).
  
  
  METHODS
  Kidney disease patients with a history of at least 5 year of diabetes mellitus or 10 year of hypertension were screened by renal artery Doppler ultrasonography. Participants were randomly assigned into two groups to receive atorvastatin, 20 mg/d, with and without NER, 500 mg/d, for 16 weeks. Serum levels of lipid profile, creatinine, and nitrate were compared before and after the study.
  
  
  RESULTS
  Fifty-four patients received the statin and 51 received statin-NER combination. Both statin and statin-NER groups demonstrated significant decreases in plasma levels of TC and low-density lipoprotein cholesterol. Triglyceride and very low-density lipoprotein cholesterol were significantly lowered only with statin-NER combination. The increase in HDLC level was found in both groups, but significant only with statin-NER combination therapy (P < .001). Atorvastatin combined with NER reduced TC/HDLC ratio almost double as compared with that of atorvastatin alone (102% and 36.6% reduction, respectively). A similar pattern was observed for nitrate levels (33% and 65%, respectively).
  
  
  CONCLUSIONS
  These findings indicated that a reduction in TC/HDLC ratio improves endothelial function in renovascular disease and use of NER in combination with atorvastatin may provide better outcomes. This could be helpful in attenuating further vascular damage and associated systemic complications.
authors.affiliation: Department of Physiology, University of Karachi, Karachi, Pakistan. ghazmeen@gmail.com.
authors.forename: Ghazala
authors.initials: G
authors.lastname: Yasmeen
authors.forename: Manohar Lal
authors.initials: ML
authors.lastname: Dawani
authors.forename: Tabassum
authors.initials: T
authors.lastname: Mahboob
mesh_terms: D000328:Adult; D000069059:Atorvastatin; D015415:Biomarkers / Q000097:blood; D008076:Cholesterol, HDL / Q000097:blood*; D003692:Delayed-Action Preparations; D004359:Drug Therapy, Combination; D004730:Endothelium, Vascular / Q000187:drug effects* / Q000503:physiopathology; D005260:Female; D006538:Heptanoic Acids / Q000627:therapeutic use*; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D007511:Ischemia / Q000097:blood / Q000175:diagnosis / Q000188:drug therapy* / Q000503:physiopathology; D007674:Kidney Diseases / Q000097:blood / Q000175:diagnosis / Q000188:drug therapy* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D009525:Niacin / Q000627:therapeutic use; D009566:Nitrates / Q000097:blood; D010154:Pakistan; D011758:Pyrroles / Q000627:therapeutic use*; D020127:Recovery of Function; D012077:Renal Artery / Q000000981:diagnostic imaging / Q000187:drug effects* / Q000503:physiopathology; D013997:Time Factors; D016896:Treatment Outcome; D018608:Ultrasonography, Doppler
chemical_list: D015415:Biomarkers; D008076:Cholesterol, HDL; D003692:Delayed-Action Preparations; D006538:Heptanoic Acids; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D009566:Nitrates; D011758:Pyrroles; D009525:Niacin; D000069059:Atorvastatin