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Associations between change in C-reactive protein and serum lipids during statin treatment
T E Strandberg1, H Vanhanen, M J Tikkanen
1Department of Medicine, University of Helsinki, Finland. timo.strandberg@hus.fi
Insights
Statin therapy for high cholesterol significantly lowers C-reactive protein (CRP), a marker of inflammation. This reduction is linked to improvements in high-density lipoprotein (HDL) cholesterol, suggesting HDL has anti-inflammatory effects.
Area of Science:
- Cardiology
- Biochemistry
- Pharmacology
Background:
- Statin treatment (HMG-CoA reductase inhibitors) reduces cardiovascular risk.
- Statins are associated with decreased C-reactive protein (CRP) levels.
- Limited data exists on the relationship between CRP and lipid changes during statin therapy.
Purpose of the Study:
- To investigate the association between changes in CRP and lipid profiles in hypercholesterolemic patients undergoing statin treatment.
- To explore the relationship between CRP and specific lipid parameters, including LDL, HDL, and triglycerides.
Main Methods:
- A study of 60 hypercholesterolemic coronary patients from the Treat to Target (3T) study.
- Comparison of atorvastatin and simvastatin treatment over 12 months.
- Measurement of serum lipids and sensitive CRP levels at baseline and after 12 months.
Main Results:
- Statin treatment significantly decreased LDL cholesterol and increased HDL cholesterol.
- A significant decrease in CRP concentrations was observed during statin treatment (P = 0.03).
- Changes in CRP were significantly associated with changes in HDL cholesterol (r = -0.45; P < 0.001) and apolipoprotein A1 (r = -0.40; P < 0.001).
- Changes in LDL cholesterol and triglycerides were not significantly associated with CRP changes.
- HDL cholesterol changes accounted for 20% of the CRP changes observed.
Conclusions:
- Statin therapy effectively reduces CRP levels in hypercholesterolemic patients.
- The anti-inflammatory effects of statins may be partly mediated by improvements in HDL cholesterol.
- Findings support the hypothesis that HDL cholesterol possesses anti-inflammatory properties.
Abstract:
Hypolipidaemic 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase inhibitor (statin) treatment reduces cardiovascular risk and is also associated with the reduction of C-reactive protein (CRP) concentrations. However, there is scant data concerning the relationship between CRP and lipid changes during statin treatment. We studied 60 hypercholesterolaemic coronary patients who participated in the Treat to Target (3T) study comparing atorvastatin and simvastatin. Serum lipids and CRP (with a sensitive method) were measured before treatment at baseline and after 12 months of statin treatment. Low-density lipoprotein (LDL) cholesterol was substantially decreased and high-density lipoprotein (HDL) cholesterol increased during statin treatment. CRP decreased significantly (sign test P = 0.03) during treatment, and the changes of CRP were significantly associated with changes in HDL cholesterol (r = -0.45; P < 0.001) and apolipoprotein A1 (r = -0.40; P < 0.001) but not with changes in LDL cholesterol or triglycerides. The change in HDL cholesterol explained 20% of the change in CRP during statin treatment. The results are in line with previous suggestions that HDL has anti-inflammatory properties.