乌尔索西胆酸用于跨肠道胆固醇分泌刺激:一个随机的安慰剂控制交叉研究
Reindert F Oostveen1, Yannick Kaiser1, Merel L Hartgers1
1Department of Vascular Medicine, Amsterdam Cardiovascular Sciences Amsterdam UMC, University of Amsterdam The Netherlands.
Journal of the American Heart Association
|October 8, 2024
概括
乌尔索多西胆酸 (UDCA) 没有增加便中性固醇,这是跨肠道胆固醇分泌 (TICE) 的标记物. 这种爱用胆汁酸的治疗,与ezetimibe结合,意外地提高了人类的LDL胆固醇水平.
科学领域:
- 生物化学和新陈代谢
- 心血管研究研究心血管研究
- 胃肠病学 胃肠病学
背景情况:
- 超肠道胆固醇分泌 (TICE) 是降低血LDL胆固醇的一种途径.
- TICE涉及肠细胞直接将胆固醇分泌到便中.
- 在小鼠中,TICE是由性胆酸刺激的,增加了便中的醇损失,降低了血胆固醇.
研究的目的:
- 调查水友性胆酸ursodeoxycholic acid (UDCA) 是否会增加人类便中性固醇.
- 为了评估UDCA对跨肠道胆固醇分泌 (TICE) 途径的影响,作为代理.
- 评估UDCA与ezetimibe联合对血LDL胆固醇水平的影响.
主要方法:
- 一个随机,双盲,安慰剂控制的交叉试验,涉及20名男性参与者,LDL胆固醇≥2.6 mmol/L.
- 参与者每天接受ezetimibe 20 mg 3 周,然后随机分配到UDCA 600 mg或每天安慰剂 2 周.
- 在替代治疗之前进行了为期3周的洗期;测量了便中性固醇和血LDL胆固醇.
主要成果:
- 与安慰剂相比,UDCA治疗显著降低了血胆酸水性 (P<0.001).
- 便中性固醇分泌在UDCA和安慰剂组之间没有显著变化 (P=0.51).
- 与安慰剂相比,UDCA治疗导致LDL胆固醇显著增加 (+8.1%与-3.64%,P=0.002).
结论:
- 当UDCA与ezetimibe相结合时,会增加人类的胆酸水友性,但不会增强便中性固醇的分泌.
- 这些发现表明,在人类中,增加胆酸池水友性不会刺激TICE.
- 这种组合疗法没有降低LDL胆固醇,而是意外地增加了它,挑战了UDCA在TICE刺激中的作用.
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