Effect Of Simvastatin And Niacin On Adiponectin And Hs-CRP In Arteriosclerosis Patients

ObjectiveIn the pathogenesis of atherosclerosis, inflammatory is considered as an important factor in both produce and evolution . Adiponectin (Adiponectin APN)is a cytokine secreted by fat cells.It can regulate glucose and lipid metabolism, improve insulin sensitivity.It can resist atherosclerosis and inflammatory. High sensitivity C-reactive protein (hs-CRP) is recognized as one of the inflammatory markers .It can effect vascular endothelial cells directly. This study was about atherosclerosis patients taking niacin and simvastatin ,observed the changes of APN and hs-CRP levels, confirmed that simvastatin may increase atherosclerosis patients'adiponectin levels, decrease the level of hs-CRP. To detect niacin's vascular protective effect.MethodsAll patients were given oral administration of simvastatin 40mg daily .And after 4 weeks , HDL, LDL, TC, TG, APN, hs-CRP levels were measured.Then the patients were randomly divided into two groups: one group uses simvastatin only (70 persons) while another one uses 2g niacin conjunct with simvastatin (70 persons). After another 8 weeks treatment, the above parameters were measured once again and given statistical analysis. We exclued the patients who had significant fluctuations in blood glucose, skin flushing, and those who can not tolerate side effects or require hospital treatment applied to other drugs affect the lipid metabolism of patients after nicotinic treatment. All patients were fasted for more than 8 hours, and in the next morning venous blood samples were collected with fasting condition. The samples were added 5 ml with 0. 2 ml2% EDTA anticoagulant tubes, 3 000 r / min centrifugation 30 min, the supernatant was processed in -20℃frozen tested. Using enzyme-linked immunosorbent assay (ELISA) to measure the determination of plasma adiponectin and CRP levels before and after the treatment, while blood lipids and liver function were measured by Beckman Coulter LX20 automatic biochemical analyzer (BECKMAN COULTER LX20). Correlation between groups of data using t test, and Pearson correlation analysis, the difference was statistically significant if P<0.05.Results(1)After 4 weeks of simvastatin treatment, APN of AS patients was higher than the normal range, while hs-CRP decreased to normal range, 4 terms of blood lipids were under controlled. (2) The baseline plasma adiponectin levels of the two groups showed no significant difference (P> 0.05), After 8 weeks conjunction with niacin, the difference was statistically significant (Z=-4.780, P=0.000); baseline HDL of two groups of patients showed no significant difference (P> 0.05), After 8 weeks conjunction with niacin, the difference was statistically significant (t=4.103, P=0.000). (3) After 8 weeks conjunction with niacin, the level of APN was negative correlation to TG while positive correlation to HDL.ConclusionSimvastatin treatment decreased the serum CRP level while increase the serum APN level in patients with AS.Combined with niacin,the rise of APN and the drop of CRP were futher more significant ,and the blood lipids conditions was significantly improved. Niacin's vascular protection effects were depends on the improvement of blood lipid,raising the level of APN and Reducing of the inflammatory response.