No effect of switching to high-dose rosuvastatin, add-on nicotinic acid, or add-on fenofibrate on serum vitamin D levels in patients with mixed dyslipidemia

作者：Makariou E S; Elisaf M^*; Kei A; Challa A; DiNicolantonio J J; Liberopoulos E

来源：Hippokratia, 2015, 19(2): 136-140.

• vitamin D
• cardiovascular disease
• statins
• rosuvastatin
• fenofibrate
• nicotinic acid
• laropiprant

Background: Low 25-hydroxy-vitamin D [25(OH) VitD] levels may represent a novel cardiovascular disease risk factor. Several statins may increase 25(OH) VitD concentration. The effect of other lipid-lowering drugs is unknown.
Aim: To investigate whether switching to high-dose rosuvastatin, add-on-statin nicotinic acid or add-on-statin fenofibrate would alter 25(OH) VitD levels in patients with mixed dyslipidemia who are already on a conventional statin dose.
Methods: This is a prespecified analysis of a previously published study. Forty-four patients with mixed dyslipidemia not at treatment goal despite treatment with simvastatin 10-40 mg or atorvastatin 10-20 mg or rosuvastatin 5-10 mg were randomly allocated to switch to rosuvastatin 40 mg (n = 17), add-on-statin extended release nicotinic acid (ER-NA)/laropiprant (LRPT) (1000/20 mg first four weeks and 2000/40 mg thereafter) (n = 14), or add-on-statin micronized fenofibrate (200 mg) for three months. The endpoint for this analysis was between-group difference in changes in 25(OH) VitD levels.
Results: Serum 25(OH) VitD levels did not significantly change in any group. In the switch to the highest dose of rosuvastatin group and the add-on-statin ER-NA/LRPT group there was an insignificant decrease in 25(OH) VitD levels {-4.7% [from 16.8 (3.2-37) to 16.0 (7.9-51.6)] and -14.8% [from 12.8 (2.0-54.8) to 10.9 (2.4-34)], respectively]}, while in the add-on-statin fenofibrate group there was an insignificant increase [+13% (from 14.5 (1.0-42) to 16.4 (4.4-30.4) ng/mL)]. No significant difference between groups was found.
Conclusion: In patients already on a conventional statin dose, neither switching to high-dose rosuvastatin (40 mg) nor add-on-statin ER-NA/LRPT or fenofibrate were associated with significant changes in 25(OH) VitD serum levels.

• 出版日期2015