Key result
Atorvastatin 80 mg per day for 4 weeks reduced plasma levels of VLDL triglycerides by ~50% (P<0.05) and decreased liver triglyceride mass compared to placebo.
Why the study?
Does atorvastatin 80 mg per day alter hepatic gene expression and reduce liver triglyceride mass in human subjects?
RCT (n=19)
Randomly assigned
Does atorvastatin 80 mg per day alter hepatic gene expression and reduce liver triglyceride mass in human subjects?
Effect estimate: ~50% reduction
p-value: p=< 0.05
High-dose atorvastatin reduces liver triglyceride mass and alters hepatic gene expression, including reducing ANGPTL3 mRNA, which may contribute to lower VLDL TG levels.
May benefit patients with steatosis and hypertriglyceridemia; extends mechanistic evidence linking atorvastatin to ANGPTL3 suppression.
Pramfalk C, Parini P, Gustafsson U, Sahlin S, Eriksson M (Department of Laboratory Medicine, Division of Clinical Chemistry; Department of Biosciences and Nutrition, Centre for Nutrition and Toxicology, Molecular Nutrition Unit, NOVUM; Department of Surgery, Karolinska Institutet at Danderyd Hospital, Danderyd; Department of Endocrinology, Metabolism Unit, Metabolism and Diabetes, and Department of Medicine, Karolinska Institutet at Karolinska University Hospital Huddinge, S-141 86 Stockholm, Sweden). Effects of high-dose statin on the human hepatic expression of genes involved in carbohydrate and triglyceride metabolism. J Intern Med 2010; 269: 333–339. Objectives: Atorvastatin, an inhibitor of 3-hydroxy-3-methylglutaryl-coenzyme A reductase, the rate-limiting enzyme in cholesterol synthesis, lowers plasma cholesterol and triglyceride (TG) levels dose dependently. The aim of this study was to investigate the molecular mechanism(s) of this decrease in plasma TG levels in atorvastatin-treated subjects. Research Design and Methods: Lipoprotein separation and plasma analysis of lipids, glucose and insulin were performed in subjects randomly assigned to placebo (n = 9) or atorvastatin (80 mg per day) (n = 10) for 4 weeks. Liver TG mass was determined in pooled samples. Hepatic expression of several genes involved in carbohydrate and TG metabolism was determined. Results: Atorvastatin lowered plasma levels of very low-density lipoprotein (VLDL) TG (∼50%, P < 0.05) and liver TG mass compared to placebo. Except for cholesterol changes, there were no other significant differences in plasma lipids, glucose or insulin. However, atorvastatin reduced mRNA expression of sterol regulatory element-binding protein 1c (SREBP1c) (>30%, P < 0.05), glucokinase (∼50%, P < 0.05) and angiopoietin-like protein 3 (ANGPTL3) (∼25%, P < 0.01), and induced mRNA expression of acetyl-coenzyme A carboxylase 1 (∼45%, P < 0.05) and glucose-6-phosphatase (∼90%, P < 0.05) compared to placebo. Conclusions: Following treatment with atorvastatin, reduced ANGPTL3 mRNA expression may contribute to the reduced plasma levels of VLDL TG. The reduced liver TG mass induced by a high dosage of atorvastatin may be important for the treatment of patients with fatty liver.
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Pramfalk et al. (2010) reported an RCT. Atorvastatin vs. Placebo was evaluated on Plasma levels of very low-density lipoprotein (VLDL) triglycerides (~50% reduction, p=< 0.05). Atorvastatin 80 mg per day for 4 weeks reduced plasma levels of VLDL triglycerides by ~50% (P<0.05) and decreased liver triglyceride mass compared to placebo.
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