Effect of very-low-dose niacin on high-density lipoprotein in patients undergoing long-term statin therapy.
Effect of very-low-dose niacin on high-density lipoprotein in patients undergoing long-term statin therapy.
复制标题
极低剂量烟酸对长期接受他汀类药物治疗的患者高密度脂蛋白的影响。
DOI：
10.1067/mhj.2002.120158
复制
发表时间：
2002
影响因子：
4.8
通讯作者：
J. King
中科院分区：
文献类型：
--
作者：
J. Wink;G. Giacoppe;J. King
背景
低水平的高密度脂蛋白(HDLC)已被证明是冠状动脉疾病的危险因素。烟酸可提高高密度脂蛋白胆固醇水平，但由于其副作用很少使用。烟酸的副作用与剂量有关。这项研究验证了这样一种假设，即非常低剂量的烟酸与长期的他汀类药物治疗相结合，将通过显著提高HDLC水平来改善血脂状况，而且副作用比传统剂量的烟酸更少。
方法
50名接受稳定的他汀类药物治疗3个月的患者被随机分为安慰剂或烟酸50 mg，每日2次口服，共3个月。糖尿病患者和经常吸烟的人被排除在外。每个患者在治疗前后都完成了一份关于目前的医疗问题、药物和生活方式的调查问卷。患者被问及在药物试验期间可能出现的任何副作用。主要终点是HDLC水平的变化和患者报告的副作用。
结果
39名患者完成了这项研究。在他汀类药物治疗的基础上加用非常小剂量的烟酸可增加平均高密度脂蛋白胆固醇，烟酸组的平均高密度脂蛋白胆固醇为2.1mgdL(平均标准差为0.767)，而安慰剂组的平均高密度脂蛋白胆固醇为-0.56mgdL(经方差分析，平均标准差为-0.816，P=0.0246)。5名接受烟酸治疗的患者与2名接受安慰剂治疗的患者相比，出现了潮红现象。未发现重大副作用。没有患者因副作用而停止研究用药。
结论
在他汀类药物治疗中加入极低剂量的烟酸可显著增加高密度脂蛋白胆固醇，同时避免了与传统剂量的烟酸治疗相关的副作用。
BACKGROUND
A low level of high-density lipoprotein (HDLC) is a proven risk factor for coronary artery disease. Niacin raises HDLC levels, but it is infrequently used because of its side effect profile. Niacin's side effects are dose related. This study tests the hypothesis that very low-dose niacin, in conjunction with long-term statin therapy, will improve the lipid profile by significantly raising the level of HDLC, with fewer side effects than traditional doses of niacin.
METHODS
Fifty patients undergoing stable statin therapy for 3 months were blindly randomized to receive either placebo or niacin 50 mg administered by mouth 2 times daily for 3 months. Patients with diabetes and active smokers were excluded. Each patient completed a questionnaire regarding current medical problems, medications, and lifestyle before and after the therapy. Patients were questioned about any possible side effects that occurred during the medication trial. The primary end points were change in HDLC level and patient-reported side effects.
RESULTS
Thirty-nine patients completed the study. Very low-dose niacin added to statin therapy increased the mean HDLC, 2.1 mg/dL in niacin group (standard error of the mean, 0.767) versus -0.56 mg/dL for placebo group (standard error of the mean-.816, P =.0246 by analysis of variance). Five patients receiving niacin, versus 2 patients receiving placebo, had episodes of flushing. No major side effects were noted. No patients stopped the study medication as a result of side effects.
CONCLUSIONS
The addition of very low-dose niacin to statin therapy increased HDLC cholesterol significantly, while avoiding the side effects that are associated with traditional doses of niacin therapy.
影响因子：
120.7
作者：
Elam, MB;Hunninghake, DB;Brinton, EA
通讯作者：
Brinton, EA
低剂量结晶烟酸对高密度脂蛋白胆固醇水平低的男性的有效性。
DOI：
--
发表时间：
1996
期刊：
Archives of internal medicine.
影响因子：
--
作者：
Martin-Jadraque,R;Tato,F;Mostaza,JM;Vega,GL;Grundy,SM
通讯作者：
Grundy,SM