In primary hypercholesterolemia, atorvastatin 10 mg was more effective and nonequivalent to simvastatin 20 mg and significantly more effective than simvastatin 10 mg for reducing LDL cholesterol levels.
Atorvastatin is a drug of choice in the treatment of coronary heart disease, because this hepatic 3-hydroxy-3-methylglutaryl coenzyme reductase inhibitor significantly decreases plasma cholesterol and triglyceride levels. However, little is known about the underlying molecular targets of this drug. Lipoprotein lipase (LPL), an enzyme with multiple functions in non-hepatic lipid metabolism, may be a potential candidate and LPL gene expression may increase in response to a treatment with atorvastatin. In order to verify this hypothesis, mouse 3T3-L1 preadipocytes were incubated with 1 and 10 µmol/l atorvastatin for 24 and 48 h and LPL mRNA concentration was measured by reverse transcription-polymerase chain reaction. Our data indicated that atorvastatin increased LPL mRNA concentration by a time- and dose-dependent mechanism. LPL mRNA concentration was significantly increased by 82% with 10 µmol/l atorvastatin after 48 h. LPL mRNA concentration was 28% greater (not significant) than control with 10 µmol/l atorvastatin after 24 h. No increase was obtained with 1 µmol/l atorvastatin after 24 or 48 h. The first 976 nucleotides of rat LPL promoter were transfected in 3T3-L1 preadipocytes. Addition of 10 µmol/l atorvastatin for 48 h resulted in a 44% increase of rat LPL promoter activity. This study demonstrates for the first time that a statin can regulate LPL gene expression transcriptionally in preadipocytes.
Perception of a chronic illness is a driver of patient behaviour that may impact treatment outcomes. The cross-sectional PETRA study was designed to describe the links between disease perception, patient behaviour and treatment outcomes in adults with allergic rhinitis (AR). Overall, 687 French general practitioners (GPs) included 1929 analysable patients (mean age: 39 years; intermittent/persistent symptoms: 46.2/52.3%). Of the patients, 14.1% had also been diagnosed with asthma; 71.7% had uncontrolled AR (ARCT score < 20), and 53.6% had a good perception of their illness (BIPQ score < 5). Factors significantly associated with poor perception of AR were ENT (ear/nose/throat) complications, nasal pruritus, uncontrolled AR and asthma. A strong negative correlation was observed between the BIPQ and ARCT scores: the poorer the patient's perception, the less the AR was controlled. Although no causal relationship could be drawn, GP-driven improvement of AR perception could lead to better control of symptoms.
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