The Effects of Folic Acid and Atorvastatin Treatment on Homocysteine and Lipid Levels in Hyperlipidemic Patients

Öz

Objectives: Hyperlipidemia is conventional risk factors of atherosclerosis. In addition, hyperhomocysteinemia was also shown to lead to accelerated atherosclerosis. One of the leading causes of the increase in homocysteine levels is insufficient folic acid intake. Folic acid administration was demonstrated to protective effects on atherosclerosis. In the present study we aimed to investigate the effects of atorvastatin and folic acid administration on lipid profile and homocystein in the treatment of hyperlipidemia, an atherosclerosis risk factor. Materials and Methods: The study included 60 combined hyperlipidemic patients. The patients were randomly allocated to three groups. Only atorvastatin to first group, only folic acid to second group and atorvastatin and folic acid to third group were administered. The study lasted 12 weeks. Lipids and homocysteine levels were studied at the beginning and in the 4th and 12th weeks. Results: It was seen that the group that was administered atorvastatin only had significant changes in the lipids, but not in homocysteine level. The group that received folic acid only was found to have no change in the lipid profile, but had a significant decrease in homocysteine levels. The group that was administered both atorvastatin and folic acid was observed to undergo significant changes in both. Conclusion: Addition of folic acid to atorvastation treatment significantly reduced homocysteine levels, but wasn't observed to have an additional effect on lipids. Evaluation of homocysteine levels in individuals have atherosclerosis risk factors like hyperlipidemia and administration of treatment if the levels are found high, will confer extra benefits in atherosclerosis. ©2006, Fırat Üniversitesi, Tıp Fakültesi

Anahtar Kelimeler

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Hiperlipidemik Hastalarda Folik Asit ve Atorvastatin Tedavisinin Homosistein ve Lipit Düzeylerine Etkisi

Öz

Amaç: Hiperlipidemi; aterosklerozun konvansiyonel risk faktörlerindendir. Bununla birlikte hiperhomosisteineminin de hızlanmış ateroskleroza yol açtığı ortaya konulmuştur. Homosistein artışının en önemli sebeplerinden birisi ise folik asit alım yetersizliğidir. Oral folik asit uygulamasının ateroskleroz üzerine protektif etkileri gösterilmiştir. Bu çalışmada ateroskleroz risk faktörlerinden olan hiperlipideminin tedavisinde atorvastatin ve folik asit uygulanmasının lipit profili ve homosistein üzerine etkilerini incelemek amaçlandı. Gereç ve Yöntem: Çalışmaya 60 kombine hiperlipidemik hasta alındı. Hastalar üç gruba randomize edildi. Birinci gruba sadece atorvastatin, ikinci gruba sadece folik asit, üçüncü gruba atorvastatin ve folik asit oral verildi. Çalışma 12 hafta sürdü. Tüm hastalarda çalışma başlangıcında, çalışmanın 4. ve 12. haftalarında lipit profili ve plazma homosistein düzeyleri çalışıldı. Bulgular: Sadece atorvastatin alan grupta lipid profilinde anlamlı değişiklikler gözlenmesine karşın, homosistein düzeyinde değişiklik gözlenmedi. Sadece folik asit alan grupta ise lipid profilinde değişiklik gözlenmez iken homosistein düzeyleri anlamlı geriledi. Atorvastatin ve folik asit alan grupta ise hem lipid profili hem de homosistein düzeylerinde anlamlı değişiklikler gözlendi. Sonuç: Atorvastatin tedavisine folik asit ilave edilmesi homosistein düzeyini anlamlı geriletmiş olmasına karşın lipit profili üzerine ilave etkisi gözlenmemiştir. Hiperlipidemi gibi ateroskleroz risk faktörlerinden birisini taşıyan bireylerde homosistein düzeylerinin değerlendirilmesi ve yüksek ise tedavisi ateroskleroz üzerine ilave yararlar sağlayacaktır. ©2006, Fırat Üniversitesi, Tıp Fakültesi

Anahtar Kelimeler

• Hiperlipidemi, homosistein, folik asit, atorvastatin

Kaynakça

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43. Kabul Tarihi: 28.02.2006