摘要

AIM:The PLANET trials showed that atorvastatin 80 mg but not rosuvastatin at either 10 or 40 mg reduced urinary protein to creatinine ratio (UPCR) at similar effects on LDL-cholesterol. However, individual changes in both UPCR and LDL-cholesterol during treatment with these statins varied widely between patients. This inter-individual variability could not be explained by patients' physical or biochemical characteristics. We assessed whether the plasma concentrations of both statins were associated with LDL-cholesterol and UPCR response.
MATERIALS AND METHODS:The PLANET trials randomized patients with a UPCR of 500-5000 mg/g and fasting LDL-cholesterol >2.33 mmol/L to a 52-week treatment with atorvastatin 80 mg, rosuvastatin 10 mg or 40 mg. For the current analysis, patients with available samples at week 52 and treatment compliance >80% by pill count were included (N = 295). The main outcome measurements were percentage change in UPCR and absolute change in LDL-cholesterol (delta LDL) from baseline to week 52.
RESULTS:Median (interquartile range) plasma concentration at week 52 for atorvastatin 80 mg was 3.9 ng/mL (IQR: 2.1 to 8.7), for rosuvastatin 10 mg 1.0 ng/mL (IQR: 0.7 to 2.0) and for rosuvastatin 40 mg 3.5 ng/mL (IQR: 2.0 to 6.8). Higher plasma concentration of statin was associated with larger LDL-cholesterol reductions at week 52 [rosuvastatin r = -0.40 (P 

译文

目的: PLANET 试验显示，在 10 或 40 毫克的情况下，阿伐他汀 80 毫克而不是瑞舒伐他汀可降低尿蛋白与肌酐比值 (UPCR)，对低密度脂蛋白胆固醇的影响相似。然而，在这些他汀类药物治疗期间，UPCR 和 LDL-胆固醇的个体变化在患者之间差异很大。这种个体间的变异性不能用病人的身体或生化特征来解释。我们评估了两种他汀类药物的血浆浓度是否与低密度脂蛋白胆固醇和 UPCR 反应相关。
材料和方法: PLANET 试验将 UPCR 为 500-5000 毫克/克，空腹低密度脂蛋白胆固醇> 2.33 毫摩尔/升的患者随机分为 52 周，用他汀类药物治疗 80 毫克, 瑞舒伐他汀 10 毫克或 40 毫克。对于目前的分析，包括在 52 周有可用样本且治疗依从性大于 80% 的患者 (N = 295)。主要结果测量是从基线到 52 周 UPCR 的百分比变化和 LDL-胆固醇 (delta LDL) 的绝对变化。
结果: 瑞舒伐他汀 80 mg/mL 在 52 周的血浆浓度中位数 (四分位数范围) 为 3.9 ng/mL (IQR: 2.1 至 8.7)，瑞舒伐他汀 10 mg/1.0 ng/mL (IQR: 0.7-2.0) 和瑞舒伐他汀 40-mg 3.5 ng/mL (IQR: 2.0-6.8)。更高的他汀类药物血浆浓度与 52 周时更大的低密度脂蛋白胆固醇减少相关 [瑞舒伐他汀 r =-0.40 (p