THE INFLUENCE OF HYPOLIPIDEMIC THERAPY ON THE LEVEL OF MODIFIED LOW DENSITY LIPOPROTEIDES

Abstract

Aim. To assess the influence of coronary heart disease patients (CHD) therapy with statins or PCSK9 inhibitors influence on the level of oxidatively modified low density lipoproteides (LDL) and activity of erythrocyte Se-glutathione peroxidase (GSH-Px).

Material and methods. To the study, CHD patients were included (9-10 males per group), who during 6 months were undergoing statin therapy — 40 mg per day of pravastatin (group 1) or 0,4 mg per day of cerivastatin (group 2), as the therapy with PCSK9 inhibitor — 420 mg per month evolocumab (group 3) during 1 year. The level of lipohydroperoxide in LDL (LOOH-LDL) was measured in the groups 1 and 2 with the modified method and usage of Fe-xilenolorange; content of oxidized LDL (oxLDL) in the group 3 — with immune chemistry method (assays Mercodia, Sweden). Activeness of GSH-Px in all groups was assessed with the modified methods bound with glutathione reductase system and tret-buthyl hydroperoxide as a substrate.

Results. Simultaneously with the decrease of LDL cholesterol in the groups 1 and 2 there was significant increase (in the group 2 — 6-7 times in 3-6 months of therapy) of the level of LOOH-LDL. In the group 2 there was marked significant decrease of GSH-Px activity beginning from the month 3. In the group 3, with decreased LDL cholesterol there was significant decline in oxLDL with changed activity of GSH-Px.

Conclusion. Statins, effectively decreasing the level of LDL cholesterol, simultaneously induce the oxidation of LDL and decrease the activity of GSH-Px. Inhibitor PCSK9 not only does effectively decrease the level of LDL cholesterol, but also the content of oxLDL, not leading to decreased GSH-Px activity.