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題名 | 關節炎病患低劑量甲氨蝶呤用藥與血脂相關性之前趨研究=Low-dose Methotrexate Treatment Is Associated with Increased Total Cholesterol and HDL-Cholesterol in Blood: A Pilot Study |
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作 者 | 池惠民; 張馨月; 陳得源; 藍忠亮; 蔣恩沛; | 書刊名 | 臺灣營養學會雜誌 |
卷期 | 35:4 2010.12[民99.12] |
頁次 | 頁157-164 |
分類號 | 418.2216 |
關鍵詞 | 類風濕性關節炎; 甲氨蝶呤; 心血管疾病; 泡沫細胞; 高密度脂蛋白膽固醇; 低密度脂蛋白膽固醇; Rheumatoid arthritis; Methotrexate; Cardiovascular risk; Foam cell; High-density lipoprotein cholesterol; Low-density lipoprotein cholesterol; |
語文 | 中文(Chinese) |
中文摘要 | 類風濕性關節炎病患有較高的心血管疾病風險。過去研究指出甲氨蝶呤降低病患之發炎並抑制感染,並有助於預防代謝症候群及預防動脈粥狀硬化。細胞實驗曾發現甲氨蝶呤會提升巨噬細胞膽固醇代謝基因表現。然而使用甲氨蝶呤是否會影響類風濕性關節炎病患心血管疾病危險因子仍待進一步研究。本研究探討類風濕性關節炎病患,服用甲氨蝶呤與否與血中脂質之相關性。研究發現服用甲氨蝶呤之受測者其血中高密度脂蛋白膽固醇(high-density lipoprotein cholesterol: HDL-C)與血液中總膽固醇(total cholesterol)的濃度較高。但三酸甘油脂(triglycerides)、低密度脂蛋白膽固醇(low-density lipoprotein cholesterol: LDL-C)濃度則無顯著差異。本研究中兩組受測者健康狀況及飲食脂肪攝取無顯著差異,因此推論兩組病患其血液中高密度脂蛋白膽固醇及總膽固醇的不同並非導因於飲食或健康狀況差異。本研究發現臨床上類風濕性關節炎受測者服用甲氨蝶呤藥物可能會影響膽固醇代謝進而影響心血管疾病發生。未來將進行大型研究探討甲氨蝶呤如何進一步影響膽固醇代謝。 |
英文摘要 | Low-dose methotrexate (MTX) is a commonly prescribed disease-modifying anti-rheumatic drug (DMARD) for treating rheumatoid arthritis (RA). A previous in vitro study indicated that MTX can induce proteins that promote cellular cholesterol efflux. The objective of the present study was to examine whether clinical MTX use is associated with altered blood lipids. In this pilot study, 44 RA patients were recruited from Taichung Veterans General Hospital. Blood lipid profiles were compared between subjects taking MTX (MTX+) and those taking other DMARDs (MTX-). Although no difference was observed in blood triglycerides (TGs) or low-density lipoprotein (LDL)-cholesterol between MTX+ and MTX- subjects, total cholesterol and high-density lipoprotein (HDL)-cholesterol were significantly lower in MTX+ subjects (n=22) compared to MTX- subjects (n=22, p<0.05). In conclusion, we demonstrated the atheroprotective potential of low-dose clinical use of MTX. We suggest that the impacts of MTX may be associated with induction of ATP-binding cassette transporter A1 (ABCA) and 27-hydroxylase (27HY) in humans. Further studies with larger sample sizes investigating the impacts of low-dose MTX on the blood lipid profile and ABCA and 27HY are warranted. |
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