title: [Association between very low density lipoprotein cholesterol and cholesterol absorption/synthesis markers in patients with moderate and high risk of coronary heart disease].
abstract: OBJECTIVE
  To evaluate the association between very low density lipoprotein cholesterol (VLDL-C) and cholesterol absorption and synthesis markers in patients with moderate and high risk of coronary heart disease.
  
  
  METHODS
  A total 363 statin-naïve patients with moderate and high risk of coronary heart disease were consecutively recruited from two hospitals in Shanxi and Henan provinces between October 2008 and June 2009. A standard questionnaire and physical examination were performed at baseline. Atorvastatin (20 mg/day) was administered to patients for 4 weeks. Venous blood samples after an overnight fast were collected before and after treatment for measuring VLDL-C and cholesterol absorption and synthesis markers. In qualitative analyses, the baseline level of cholesterol absorption and synthesis markers and their reduction after atorvastatin treatment were categorized into 3 tertile groups.
  
  
  RESULTS
  (1) Of 363 patients, 283 patients with mean age of (55.43±9.01)years old with complete data were finally analyzed. The median level of baseline VLDL-C was 1.06 (0.65, 1.86) mmol/L. The median level of baseline cholesterol absorption marker (Campesterol) and cholesterol synthesis marker (Lathosterol) was 6.01 (3.78, 9.45) mg/L and 13.46 (8.30, 21.07) mg/L, respectively. (2) Partial correlation analysis and multiple regression showed the baseline level of VLDL-C was positively correlated with Campesterol (r=0.153, P<0.05) but not with Lathosterol(r=0.182, P=0.173). Furthermore, baseline VLDL-C level significantly increased with tertile of the baseline level of Campesterol in the qualitative analyses(P for trend=0.035). (3) Mean reduction in VLDL-C levels was 38.0% after 4 weeks atorvastatin treatment. VLDL-C reduction was positively correlated with Campesterol reduction (r=0.331, P<0.001). VLDL-C reduction significantly increased with the tertile of Campesterol reduction (P for trend=0.032). But this trend was not observed between VLDL-C level and Lathosterol (P for trend=0.798).
  
  
  CONCLUSIONS
  The level of VLDL-C was closely related to cholesterol absorption marker, and further studies are needed to validate if inhibitor of cholesterol absorption (for example by Ezetimibe) could bring about more effective VLDL-C lowering effect in this patient cohort.
authors.affiliation: Department of Epidemiology, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing An Zhen Hospital, Capital Medical University, Beijing 100029, China.
authors.forename: Zhizhong
authors.initials: Z
authors.lastname: Gong
authors.forename: Yue
authors.initials: Y
authors.lastname: Qi
authors.forename: Fan
authors.initials: F
authors.lastname: Zhao
authors.forename: Jing
authors.initials: J
authors.lastname: Liu
authors.forename: Wei
authors.initials: W
authors.lastname: Wang
authors.forename: Jun
authors.initials: J
authors.lastname: Liu
authors.forename: Jiayi
authors.initials: J
authors.lastname: Sun
authors.forename: Wuxiang
authors.initials: W
authors.lastname: Xie
authors.forename: Yan
authors.initials: Y
authors.lastname: Li
authors.forename: Miao
authors.initials: M
authors.lastname: Wang
authors.forename: Lanping
authors.initials: L
authors.lastname: Qin
authors.forename: Ying
authors.initials: Y
authors.lastname: Wang
authors.forename: Yongchen
authors.initials: Y
authors.lastname: Hao
authors.forename: Qingxuan
authors.initials: Q
authors.lastname: Zhang
authors.forename: Xiaoping
authors.initials: X
authors.lastname: Chen
authors.affiliation: Email: deezhao@vip.sina.com.
authors.forename: Dong
authors.initials: D
authors.lastname: Zhao
mesh_terms: D000069059:Atorvastatin; D015415:Biomarkers; D002784:Cholesterol / Q000031:analogs & derivatives; D008078:Cholesterol, LDL; D015243:Cholesterol, VLDL; D003324:Coronary Artery Disease; D000069438:Ezetimibe; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D010840:Phytosterols; D012307:Risk Factors
chemical_list: D015415:Biomarkers; D008078:Cholesterol, LDL; D015243:Cholesterol, VLDL; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D010840:Phytosterols; C021273:campesterol; C001521:lathosterol; D002784:Cholesterol; D000069059:Atorvastatin; D000069438:Ezetimibe