{"id":3272,"date":"2023-04-11T17:59:52","date_gmt":"2023-04-11T10:59:52","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=3272"},"modified":"2023-04-17T16:37:07","modified_gmt":"2023-04-17T09:37:07","slug":"cholesterol","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/11\/cholesterol\/","title":{"rendered":"M\u1ee9c \u0111\u1ed9 h\u1ea1 Cholesterol khi d\u00f9ng Statins ph\u1ee5 thu\u1ed9c v\u00e0o ch\u1ebf \u0111\u1ed9 \u0103n?"},"content":{"rendered":"

Statins<\/a> l\u00e0 m\u1ed9t lo\u1ea1i thu\u1ed1c \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ec3 gi\u1ea3m m\u1ee9c \u0111\u1ed9 cholesterol trong m\u00e1u. Cholesterol l\u00e0 m\u1ed9t lo\u1ea1i m\u1ee1 c\u00f3 trong c\u01a1 th\u1ec3 v\u00e0 c\u00f3 vai tr\u00f2 quan tr\u1ecdng trong vi\u1ec7c s\u1ea3n xu\u1ea5t hormone, vitamin D v\u00e0 c\u00e1c ch\u1ea5t b\u00e9o c\u1ea7n thi\u1ebft cho c\u01a1 th\u1ec3. Tuy nhi\u00ean, m\u1ed9t m\u1ee9c \u0111\u1ed9 cholesterol cao c\u00f3 th\u1ec3 g\u00e2y ra c\u00e1c v\u1ea5n \u0111\u1ec1 s\u1ee9c kh\u1ecfe, bao g\u1ed3m b\u1ec7nh tim m\u1ea1ch v\u00e0 \u0111\u1ed9t qu\u1ef5. Tuy nhi\u00ean, t\u01b0\u01a1ng t\u00e1c thu\u1ed1c gi\u1eefa Statins v\u00e0 c\u00e1c thu\u1ed1c kh\u00e1c c\u0169ng nh\u01b0 th\u1ee9c \u0103n l\u00e0 v\u1ea5n \u0111\u1ec1 \u0111\u00e1ng \u0111\u01b0\u1ee3c quan t\u00e2m. Trong nh\u1eefng n\u0103m g\u1ea7n \u0111\u00e2y, m\u1ed1i li\u00ean h\u1ec7 gi\u1eefa m\u1ee9c \u0111\u1ed9 t\u00e1c d\u1ee5ng c\u1ee7a Statins khi d\u00f9ng chung v\u1edbi th\u1ee9c \u0103n \u0111ang \u0111\u01b0\u1ee3c ch\u00fa \u00fd \u0111\u1ebfn. D\u01b0\u1edbi \u0111\u00e2y l\u00e0 m\u1ed9t b\u00e0i b\u00e1o \u0111\u01b0\u1ee3c \u0111\u0103ng tr\u00ean trang Circulation v\u00e0o th\u00e1ng 05\/2021 v\u1edbi ti\u00eau \u0111\u1ec1: “Statins Do More Than Lower Cholesterol\u2014Depending on What You Eat?”.<\/p>\n

1. T\u1ed5ng quan v\u1ec1 Stastins<\/h1>\n

Statins (\u03b2-hydroxy \u03b2-methylglutaryl-coenzyme A [HMG-CoA] reductase inhibitors) thu\u1ed9c nh\u00f3m thu\u1ed1c \u0111\u01b0\u1ee3c k\u00ea \u0111\u01a1n th\u01b0\u1eddng xuy\u00ean nh\u1ea5t tr\u00ean to\u00e0n th\u1ebf gi\u1edbi, v\u1edbi t\u1ef7 l\u1ec7 l\u00ean t\u1edbi 33% to\u00e0n b\u1ed9 d\u00e2n s\u1ed1> 60 tu\u1ed5i \u1edf \u0110an M\u1ea1ch v\u00e0 l\u00ean \u0111\u1ebfn 80% b\u1ec7nh nh\u00e2n t\u1eeb 45 \u0111\u1ebfn 75 tu\u1ed5i m\u1eafc b\u1ec7nh tim m\u1ea1ch \u1edf Hoa K\u1ef3. Statin l\u00e0 ch\u1ea5t \u1ee9c ch\u1ebf c\u1ea1nh tranh c\u1ee7a HMG-CoA reductase, enzym gi\u1edbi h\u1ea1n t\u1ed1c \u0111\u1ed9 trong sinh t\u1ed5ng h\u1ee3p cholesterol v\u00e0 c\u00e1c isoprenoid kh\u00e1c. B\u1eb1ng c\u00e1ch gi\u1ea3m n\u1ed3ng \u0111\u1ed9 n\u1ed9i b\u00e0o c\u1ee7a cholesterol trong gan, t\u1ebf b\u00e0o gan \u0111i\u1ec1u ch\u1ec9nh c\u00e1c th\u1ee5 th\u1ec3 lipoprotein m\u1eadt \u0111\u1ed9 th\u1ea5p (LDL) \u1edf b\u1ec1 m\u1eb7t c\u1ee7a ch\u00fang d\u1eabn t\u1edbi l\u00e0m gi\u1ea3m n\u1ed3ng \u0111\u1ed9 cholesterol LDL trong huy\u1ebft t\u01b0\u01a1ng. B\u1eb1ng ch\u1ee9ng hi\u1ec7n t\u1ea1i ch\u1ec9 ra r\u1eb1ng nh\u1eefng t\u00e1c d\u1ee5ng l\u00e0m gi\u1ea3m cholesterol LDL n\u00e0y c\u1ee7a statin \u0111\u01b0\u1ee3c th\u1ec3 hi\u1ec7n trong vi\u1ec7c gi\u1ea3m nguy c\u01a1 m\u1eafc c\u00e1c b\u1ec7nh tim m\u1ea1ch b\u1ea5t l\u1ee3i v\u00e0 t\u1eed vong.<\/p>\n

C\u00e1c t\u00e1c d\u1ee5ng kh\u00e1c kh\u00f4ng ph\u1ee5 thu\u1ed9c v\u00e0o cholesterol (to\u00e0n th\u00e2n) c\u1ee7a statin \u0111\u00e3 \u0111\u01b0\u1ee3c b\u00e1o c\u00e1o trong m\u1ed9t s\u1ed1 n\u0103m. N\u0103m 1996, Vaughan v\u00e0 c\u00e1c c\u1ed9ng s\u1ef1 \u0111\u1ec1 xu\u1ea5t r\u1eb1ng \u201cStatin kh\u00f4ng ch\u1ec9 l\u00e0m gi\u1ea3m cholesterol,\u201d d\u1ef1a tr\u00ean quan s\u00e1t trong c\u00e1c nghi\u00ean c\u1ee9u can thi\u1ec7p s\u1edbm nh\u01b0 4S (Scandinavian Simvastatin Survival Study) v\u00e0 WOSCOPS (West of Scotland Coronary Prevention Study) cho r\u1eb1ng l\u1ee3i \u00edch l\u00e2m s\u00e0ng c\u1ee7a li\u1ec7u ph\u00e1p Statin xu\u1ea5t hi\u1ec7n s\u1edbm h\u01a1n b\u1ea5t k\u1ef3 t\u00e1c d\u1ee5ng d\u1ef1 ki\u1ebfn n\u00e0o \u0111\u1ed1i v\u1edbi ti\u1ebfn tri\u1ec3n c\u1ee7a m\u1ea3ng x\u01a1 v\u1eefa. M\u1ed9t l\u1eddi gi\u1ea3i th\u00edch kh\u00e1 ph\u00f9 h\u1ee3p \u0111\u00e3 \u0111\u01b0\u1ee3c \u0111\u01b0a ra b\u1eb1ng c\u00e1c th\u00ed nghi\u1ec7m nu\u00f4i c\u1ea5y t\u1ebf b\u00e0o cho th\u1ea5y t\u00e1c d\u1ee5ng \u1ee9c ch\u1ebf c\u1ee7a Statin \u0111\u1ed1i v\u1edbi ho\u1ea1t \u0111\u1ed9ng vi\u00eam c\u1ee7a \u0111\u1ea1i th\u1ef1c b\u00e0o, ch\u1ee9c n\u0103ng t\u1ebf b\u00e0o n\u1ed9i m\u00f4 v\u00e0 t\u0103ng sinh t\u1ebf b\u00e0o c\u01a1 tr\u01a1n m\u1ea1ch m\u00e1u. T\u00e1c d\u1ee5ng tr\u00ean nu\u00f4i c\u1ea5y t\u1ebf b\u00e0o cho th\u1ea5y c\u00f3 th\u1ec3 \u0111\u1ea3o ng\u01b0\u1ee3c b\u1eb1ng c\u00e1ch b\u1ed5 sung Mevalonate, nh\u01b0ng kh\u00f4ng ph\u1ea3i Squalene, m\u1ed9t ti\u1ec1n ch\u1ea5t c\u1ee7a Cholesterol, ch\u1ee9ng t\u1ecf HMG-CoA reductase c\u1ee5 th\u1ec3, nh\u01b0ng kh\u00f4ng ph\u1ee5 thu\u1ed9c v\u00e0o cholesterol, t\u00e1c d\u1ee5ng c\u1ee7a statin.<\/p>\n

H\u01a1n n\u1eefa, c\u00e1c nghi\u00ean c\u1ee9u kh\u00e1c ghi nh\u1eadn s\u1ef1 c\u1ea3i thi\u1ec7n ch\u1ee9c n\u0103ng n\u1ed9i m\u00f4 ph\u1ee5 thu\u1ed9c Oxit Nitric \u1edf nh\u1eefng b\u1ec7nh nh\u00e2n \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb b\u1eb1ng Statin. K\u1ec3 t\u1eeb \u0111\u00f3, nhi\u1ec1u nghi\u00ean c\u1ee9u tr\u00ean \u0111\u1ed9ng v\u1eadt v\u00e0 th\u1ef1c nghi\u1ec7m \u0111\u00e3 kh\u1eb3ng \u0111\u1ecbnh ch\u1eafc ch\u1eafn t\u00e1c d\u1ee5ng ch\u1ed1ng vi\u00eam, ch\u1ed1ng x\u01a1 v\u1eefa \u0111\u1ed9ng m\u1ea1ch, ch\u1ed1ng huy\u1ebft kh\u1ed1i v\u00e0 Oxit Nitric kh\u00f4ng ph\u1ee5 thu\u1ed9c LDL c\u1ee7a Statin (\u0111\u01b0\u1ee3c \u0111\u00e1nh gi\u00e1 b\u1edfi Oesterle et al).<\/p>\n

C\u00e1c t\u00e1c d\u1ee5ng \u0111\u1ed1i v\u1edbi Cholesterol c\u1ee7a Statin c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c gi\u1ea3i th\u00edch l\u00e0 HMGCoA reductase kh\u00f4ng ch\u1ec9 \u0111i\u1ec1u ch\u1ec9nh t\u1ed5ng h\u1ee3p cholesterol trong gan m\u00e0 c\u00f2n cung c\u1ea5p cho t\u1ea5t c\u1ea3 c\u00e1c t\u1ebf b\u00e0o c\u1ee7a c\u01a1 th\u1ec3 Isoprenoid li\u00ean quan \u0111\u1ebfn Prenyl h\u00f3a c\u00e1c protein t\u00edn hi\u1ec7u quan tr\u1ecdng. Isoprenoid, nh\u01b0 Farnesyl Pyrophosphate v\u00e0 Geranylgeranyl Pyrophosphate (GGPP), l\u00e0 c\u00e1c axit b\u00e9o chu\u1ed7i ng\u1eafn \u0111\u01b0\u1ee3c li\u00ean k\u1ebft v\u1edbi c\u00e1c ph\u00e2n t\u1eed t\u00edn hi\u1ec7u ph\u1ed5 bi\u1ebfn (GGPP). \u0110i\u1ec1u n\u00e0y kh\u00e1 quan tr\u1ecdng \u0111\u1ed1i v\u1edbi vi\u1ec7c \u201cneo m\u00e0ng\u201d v\u00e0 ho\u1ea1t \u0111\u1ed9ng \u0111\u1ea7y \u0111\u1ee7. Vai tr\u00f2 k\u00edch th\u00edch c\u1ee7a c\u00e1c ph\u00e2n t\u1eed t\u00edn hi\u1ec7u n\u00e0y \u0111\u1ed1i v\u1edbi s\u1ef1 t\u0103ng sinh t\u1ebf b\u00e0o, di c\u01b0, stress oxy h\u00f3a v\u00e0 s\u1ef1 tr\u00f9ng h\u1ee3p actin, c\u0169ng nh\u01b0 \u1ee9c ch\u1ebf \u00a0t\u00e1c \u0111\u1ed9ng th\u00f4ng qua qu\u00e1 tr\u00ecnh t\u1ed5ng h\u1ee3p Nitric Oxit c\u1ee7a t\u1ebf b\u00e0o n\u1ed9i m\u00f4 gi\u00fap gi\u1ea3i th\u00edch c\u00e1c t\u00e1c d\u1ee5ng ph\u1ed5 bi\u1ebfn c\u1ee7a vi\u1ec7c \u1ee9c ch\u1ebfIsoprenyl th\u00f4ng qua \u0111\u00e1p \u1ee9ng trung gian Statin.<\/p>\n

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\u1ea2nh minh h\u1ecda con \u0111\u01b0\u1eddng t\u1ed5ng h\u1ee3p Cholesterol v\u00e0 c\u00e1c Isoprenoids kh\u00e1c. Ngu\u1ed3n<\/strong>: Statins Do More Than Lower Cholesterol\u2014Depending on What You Eat? by\u00a0 Thomas Eschenhagen and Ulrich Laufs.<\/em><\/figcaption><\/figure>\n

2. C\u01a1 ch\u1ebf t\u00e1c \u0111\u1ed9ng \u0111\u1ebfn Cholesterol c\u1ee7a Statins<\/h2>\n

C\u01a1 ch\u1ebf ph\u1ed5 bi\u1ebfn n\u00e0y l\u00e0 l\u00fd do \u0111\u1ec3 ti\u1ebfn h\u00e0nh c\u00e1c th\u1eed nghi\u1ec7m Statin tr\u00ean l\u00e2m s\u00e0ng, v\u00e0 tr\u00ean th\u1ef1c t\u1ebf, th\u00f4ng qua c\u00e1c b\u1eb1ng ch\u1ee9ng thu \u0111\u01b0\u1ee3c v\u1ec1 l\u1ee3i \u00edch l\u00e2m s\u00e0ng c\u1ee7a li\u1ec7u ph\u00e1p Statin \u1edf nh\u1eefng b\u1ec7nh nh\u00e2n c\u00f3 b\u1ec7nh m\u1ea1ch m\u00e1u (v\u00ed d\u1ee5, b\u1ec7nh th\u1eadn, huy\u1ebft kh\u1ed1i t\u0129nh m\u1ea1ch, r\u1ed1i lo\u1ea1n c\u01b0\u01a1ng d\u01b0\u01a1ng), b\u1ec7nh t\u1ef1 mi\u1ec5n ( v\u00ed d\u1ee5, b\u1ec7nh \u0111a x\u01a1 c\u1ee9ng, vi\u00eam kh\u1edbp d\u1ea1ng th\u1ea5p), v\u00e0 c\u00e1c b\u1ec7nh m\u00f4 li\u00ean k\u1ebft (v\u00ed d\u1ee5: lo\u00e3ng x\u01b0\u01a1ng, b\u1ec7nh nha chu; \u0111\u01b0\u1ee3c Oesterle xem x\u00e9t). Tuy nhi\u00ean, c\u00e1c b\u1eb1ng ch\u1ee9ng v\u1ec1 t\u00e1c d\u1ee5ng kh\u00f4ng ph\u1ee5 thu\u1ed9c v\u00e0o Cholesterol c\u00f3 li\u00ean quan v\u1edbi c\u00e1c b\u1ec7nh \u1edf ng\u01b0\u1eddi th\u00ec kh\u00f4ng nh\u1ea5t qu\u00e1n v\u00e0 kh\u00f4ng th\u1ec3 \u0111\u01b0a ra c\u00e1c khuy\u1ebfn c\u00e1o h\u01b0\u1edbng d\u1eabn s\u1eed d\u1ee5ng statin trong c\u00e1c tr\u01b0\u1eddng h\u1ee3p kh\u00f4ng c\u00f3 b\u1ec7nh tim m\u1ea1ch.<\/p>\n

H\u01a1n n\u1eefa, c\u00e1c th\u1eed nghi\u1ec7m l\u1edbn h\u01a1n \u0111\u00e3 kh\u00f4ng t\u00ecm th\u1ea5y l\u1ee3i \u00edch c\u1ee7a vi\u1ec7c kh\u00f4ng ph\u1ee5 thu\u1ed9c v\u00e0o cholesterol c\u1ee7a li\u1ec7u ph\u00e1p Statin (v\u00ed d\u1ee5, trong rung nh\u0129 sau ph\u1eabu thu\u1eadt hay suy tim), v\u00e0 so s\u00e1nh \u0111\u1ecbnh l\u01b0\u1ee3ng t\u00e1c d\u1ee5ng h\u1ea1 lipid m\u00e1u v\u00e0 ch\u1ed1ng vi\u00eam (thay th\u1ebf protein ph\u1ea3n \u1ee9ng C) trong c\u00e1c th\u1eed nghi\u1ec7m l\u1edbn nh\u01b0 JUPITER (Ch\u1ee9ng minh cho vi\u1ec7c s\u1eed d\u1ee5ng Statin trong ph\u00f2ng ng\u1eeba: Th\u1eed nghi\u1ec7m can thi\u1ec7p \u0111\u00e1nh gi\u00e1 Rosuvastatin), HOPE-3 (Ph\u00f2ng ng\u1eeba k\u1ebft qu\u1ea3 tim m\u1ea1ch \u0110\u00e1nh gi\u00e1), v\u00e0 A \u0111\u1ebfn Z (Chi\u1ebfn l\u01b0\u1ee3c t\u0103ng c\u01b0\u1eddng s\u1edbm so v\u1edbi chi\u1ebfn l\u01b0\u1ee3c Simvastatin b\u1ea3o t\u1ed3n ch\u1eadm \u1edf b\u1ec7nh nh\u00e2n m\u1eafc h\u1ed9i ch\u1ee9ng m\u1ea1ch v\u00e0nh c\u1ea5p t\u00ednh Giai \u0111o\u1ea1n Z c\u1ee7a th\u1eed nghi\u1ec7m A \u0111\u1ebfn Z) kh\u00f4ng cho th\u1ea5y b\u1eb1ng ch\u1ee9ng nh\u1ea5t qu\u00e1n v\u1ec1 l\u1ee3i \u00edch tim m\u1ea1ch c\u1ee7a Statin v\u01b0\u1ee3t qu\u00e1 m\u1ee9c h\u1ea1 cholesterol.<\/p>\n

S\u1ef1 li\u00ean quan v\u1ec1 m\u1eb7t l\u00e2m s\u00e0ng c\u1ee7a c\u00e1c t\u00e1c d\u1ee5ng kh\u00f4ng ph\u1ee5 thu\u1ed9c v\u00e0o Cholesterol c\u1ee7a Statin v\u1eabn c\u00f2n kh\u00f3 x\u00e1c \u0111\u1ecbnh v\u00ec 2 l\u00fd do ch\u00ednh. Do c\u01a1 ch\u1ebf ho\u1ea1t \u0111\u1ed9ng c\u1ee7a ch\u00fang, Statin lu\u00f4n \u1ee9c ch\u1ebf t\u1ed5ng h\u1ee3p Cholesterol v\u00e0 Isoprenoid. H\u01a1n n\u1eefa, c\u00e1c nghi\u00ean c\u1ee9u l\u00e2m s\u00e0ng trong l\u0129nh v\u1ef1c tim m\u1ea1ch lu\u00f4n th\u1eed nghi\u1ec7m c\u00e1c li\u1ec7u ph\u00e1p gi\u1ea3m lipid m\u1edbi, ch\u1eb3ng h\u1ea1n nh\u01b0 Ezetimibe, ch\u1ea5t \u1ee9c ch\u1ebf PCSK9 v\u00e0 Axit Bempedoic, tr\u00ean n\u1ec1n c\u1ee7a li\u1ec7u ph\u00e1p Statin. Do \u0111\u00f3, b\u1eb1ng ch\u1ee9ng t\u1ed1t nh\u1ea5t cho l\u1ee3i \u00edch kh\u00f4ng ph\u1ee5 thu\u1ed9c v\u00e0o LDL c\u1ee7a Statin s\u1ebd \u0111\u01b0\u1ee3c ch\u1ee9ng minh t\u1eeb c\u00e1c so s\u00e1nh \u0111\u1ed1i \u0111\u1ea7u c\u1ee7a m\u1ed9t lo\u1ea1i thu\u1ed1c \u0111\u01b0\u1ee3c cho l\u00e0 ch\u1ec9 l\u00e0m gi\u1ea3m LDL cholesterol. M\u1eb7c d\u00f9 c\u00f2n thi\u1ebfu c\u00e1c th\u1eed nghi\u1ec7m l\u1edbn, nh\u01b0ng m\u1ed9t nghi\u00ean c\u1ee9u l\u00e2m s\u00e0ng nh\u1ecf tr\u00ean b\u1ec7nh nh\u00e2n suy tim cho th\u1ea5y Simvastatin c\u1ea3i thi\u1ec7n l\u01b0u l\u01b0\u1ee3ng m\u00e1u ph\u1ee5 thu\u1ed9c v\u00e0o l\u01b0u l\u01b0\u1ee3ng h\u01b0\u1edbng t\u00e2m trong khi Ezetimibe th\u00ec kh\u00f4ng.<\/p>\n

C\u00e1c b\u00e1o c\u00e1o t\u00e1c d\u1ee5ng l\u1edbn h\u01a1n c\u1ee7a Statin li\u1ec1u cao so v\u1edbi vi\u1ec7c k\u1ebft h\u1ee3p m\u1ed9t Statin v\u1edbi Ezetimibe, nh\u01b0ng m\u1ed9t l\u1ea7n n\u1eefa \u0111i\u1ec1u n\u00e0y kh\u00f4ng th\u1ec3 \u0111\u01b0\u1ee3c ch\u1ee9ng minh trong c\u00e1c nghi\u00ean c\u1ee9u kh\u00e1c c\u00f3 thi\u1ebft k\u1ebf t\u01b0\u01a1ng t\u1ef1. V\u00ec v\u1eady, vai tr\u00f2 \u0111\u1ecbnh l\u01b0\u1ee3ng c\u1ee7a c\u00e1c t\u00e1c d\u1ee5ng to\u00e0n th\u00e2n \u1edf ng\u01b0\u1eddi v\u1eabn ch\u01b0a \u0111\u01b0\u1ee3c gi\u1ea3i th\u00edch. Trong s\u1ed1 c\u00e1c b\u00e1o c\u00e1o, Zhu v\u00e0 c\u1ed9ng s\u1ef1 \u0111\u00e3 tr\u00ecnh b\u00e0y m\u1ed9t g\u00f3c nh\u00ecn m\u1edbi l\u1ea1 v\u1ec1 t\u00e1c d\u1ee5ng to\u00e0n th\u00e2n c\u1ee7a Statin. H\u1ecd b\u1eaft \u0111\u1ea7u v\u1edbi quan \u0111i\u1ec3m r\u1eb1ng GGPP c\u00f3 ngu\u1ed3n g\u1ed1c t\u1eeb Mevalonate trong h\u1ea7u h\u1ebft c\u00e1c sinh v\u1eadt s\u1ed1ng nh\u01b0ng \u0111\u00f3 l\u00e0 m\u1ed9t con \u0111\u01b0\u1eddng thay th\u1ebf ch\u1ec9 t\u1ed3n t\u1ea1i \u1edf th\u1ef1c v\u1eadt. \u0110i\u1ec1u n\u00e0y l\u00e0m t\u0103ng kh\u1ea3 n\u0103ng c\u00f3 s\u1ef1 kh\u00e1c bi\u1ec7t li\u00ean quan v\u1ec1 n\u1ed3ng \u0111\u1ed9 GGPP trong kh\u1ea9u ph\u1ea7n \u0103n. Th\u1eadt v\u1eady, \u0111\u00e1nh gi\u00e1 s\u1eafc k\u00fd v\u1ec1 n\u1ed3ng \u0111\u1ed9 GGPP cho th\u1ea5y kh\u00f4ng th\u1ec3 ph\u00e1t hi\u1ec7n \u0111\u01b0\u1ee3c GGPP trong b\u1ed9t m\u00ec, rau di\u1ebfp, b\u00f4ng c\u1ea3i xanh v\u00e0 khoai t\u00e2y, v\u00e0 n\u1ed3ng \u0111\u1ed9 th\u1ea5p trong g\u1ea1o, s\u1eefa v\u00e0 \u0111\u1eadu xanh (6 \u0111\u1ebfn 16 ng\/g); n\u1ed3ng \u0111\u1ed9 v\u1eeba trong th\u1ecbt l\u1ee3n, c\u00e0 chua v\u00e0 \u0111\u1eadu t\u00e2y;n\u1ed3ng \u0111\u1ed9 nhi\u1ec1u trong th\u1ecbt b\u00f2 (\u224870 ng\/g); v\u00e0 n\u1ed3ng \u0111\u1ed9 r\u1ea5t cao trong \u0111\u1eadu n\u00e0nh (\u2248130 ng\/g). Nh\u1eefng kh\u00e1c bi\u1ec7t n\u00e0y l\u00e0 c\u00f3 ngh\u0129a, ch\u1ec9 ra t\u00e1c \u0111\u1ed9ng kh\u00e1c bi\u1ec7t c\u1ee7a n\u1ed3ng \u0111\u1ed9 GGPP trong huy\u1ebft t\u01b0\u01a1ng (t\u1eeb m\u1ee9c c\u01a1 b\u1ea3n l\u00e0 50 ng\/mL \u0111\u1ebfn 200 ng\/mL) \u1edf chu\u1ed9t \u0111\u01b0\u1ee3c cho \u0103n c\u00e1c ch\u1ea5t b\u1ed5 sung th\u1ef1c ph\u1ea9m t\u01b0\u01a1ng \u1ee9ng \u1edf m\u1ee9c 2 g\/100 g tr\u1ecdng l\u01b0\u1ee3ng c\u01a1 th\u1ec3.<\/p>\n

Do quan t\u00e2m \u0111\u1ebfn hi\u1ec7u qu\u1ea3 \u0111i\u1ec1u tr\u1ecb ti\u1ec1m n\u0103ng c\u1ee7a Statin trong t\u0103ng \u00e1p ph\u1ed5i (PAH), c\u00e1c t\u00e1c gi\u1ea3 sau \u0111\u00f3 \u0111\u00e3 t\u1eadp trung v\u00e0o t\u00e1c \u0111\u1ed9ng c\u1ee7a ch\u1ebf \u0111\u1ed9 \u0103n u\u1ed1ng \u0111\u1ed1i v\u1edbi tu\u1ea7n ho\u00e0n ph\u1ed5i. Trong khi c\u00e1c ch\u1ebf \u0111\u1ed9 \u0103n GGPP kh\u00e1c nhau kh\u00f4ng \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn huy\u1ebft \u0111\u1ed9ng c\u01a1 b\u1ea3n ho\u1eb7c ph\u1ea3n \u1ee9ng m\u1ea1ch m\u00e1u ph\u1ed5i \u0111\u1ed1i v\u1edbi t\u00ecnh tr\u1ea1ng thi\u1ebfu oxy m\u00e3n t\u00ednh (4 tu\u1ea7n \u1edf m\u1ee9c oxy 10%), ch\u1ebf \u0111\u1ed9 \u0103n ch\u1ee9a GGPP cao (c\u0169ng nh\u01b0 b\u1ed5 sung tr\u1ef1c ti\u1ebfp GGPP) \u0111\u00e3 lo\u1ea1i b\u1ecf c\u00e1c t\u00e1c d\u1ee5ng c\u00f3 l\u1ee3i c\u1ee7a \u0111i\u1ec1u tr\u1ecb Simvastatin ( 10 mg\/kg th\u1ec3 tr\u1ecdng) c\u1ea3 trong t\u00ecnh tr\u1ea1ng thi\u1ebfu oxy v\u00e0 m\u00f4 h\u00ecnh Monocrotaline c\u1ee7a PAH.<\/p>\n

Nghi\u00ean c\u1ee9u s\u00e2u h\u01a1n n\u1eefa \u1edf c\u1ea3 chu\u1ed9t v\u00e0 trong nu\u00f4i c\u1ea5y t\u1ebf b\u00e0o cho th\u1ea5y r\u1eb1ng Simvastatin \u1ee9c ch\u1ebf RhoA v\u00e0 ROCK \u0111\u00edch (cu\u1ed9n xo\u1eafn li\u00ean k\u1ebft Rho ch\u1ee9a protein kinase), Protein Rab10 c\u00f3 li\u00ean quan \u0111\u1ebfn v\u1eadn chuy\u1ec3n qua m\u00e0ng v\u00e0 th\u1ee5 th\u1ec3 c\u1ea3m nh\u1eadn Ca2+, tr\u01b0\u1edbc \u0111\u00e2y \u0111\u00e3 \u0111\u01b0\u1ee3c ch\u1ee9ng minh l\u00e0 tham gia v\u00e0o PAH. T\u1ea5t c\u1ea3 c\u00e1c t\u00e1c d\u1ee5ng c\u1ee7a Simvastatin \u0111\u00e3 \u0111\u01b0\u1ee3c ng\u0103n ch\u1eb7n b\u1eb1ng c\u00e1ch b\u1ed5 sung GGPP trong ch\u1ebf \u0111\u1ed9 \u0103n u\u1ed1ng (2 \u00b5g\/kg th\u1ec3 tr\u1ecdng). Ng\u01b0\u1ee3c l\u1ea1i, t\u00e1c \u0111\u1ed9ng c\u1ee7a GGPP (ch\u1ebf \u0111\u1ed9 \u0103n ki\u00eang) b\u1ecb \u0111\u1ea3o ng\u01b0\u1ee3c b\u1eb1ng c\u00e1ch u\u1ed1ng \u0111\u1ed3ng th\u1eddi chi\u1ebft xu\u1ea5t t\u1ecfi c\u00f3 ch\u1ee9a n\u1ed3ng \u0111\u1ed9 cao Methyl Allylthiosulfinate ho\u1eb7c tr\u1ef1c ti\u1ebfp Methyl Allylthiosulfinate (0.5 mg\/kg th\u1ec3 tr\u1ecdng), m\u1ed9t ch\u1ea5t \u1ee9c ch\u1ebf c\u1ea1nh tranh c\u1ee7a GGPP, \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng b\u1edfi Geranylgeranyl Transferase .<\/p>\n

H\u01a1n n\u1eefa, c\u00e1c t\u00e1c gi\u1ea3 \u0111\u00e3 t\u1ea1o ra nh\u1eefng con chu\u1ed9t bi\u1ebfn \u0111\u1ed5i gen trong \u0111\u00f3 c\u00e1c v\u1ecb tr\u00ed t\u01b0\u01a1ng t\u00e1c Rab10 tr\u00ean th\u1ee5 th\u1ec3 c\u1ea3m nh\u1eadn Ca2 + b\u1ecb \u0111\u1ed9t bi\u1ebfn v\u00e0 cho th\u1ea5y chu\u1ed9t \u0111\u01b0\u1ee3c b\u1ea3o v\u1ec7 m\u1ed9t ph\u1ea7n kh\u1ecfi PAH trong \u0111i\u1ec1u ki\u1ec7n thi\u1ebfu oxy, ch\u1ee9ng t\u1ecf vai tr\u00f2 quan tr\u1ecdng c\u1ee7a th\u1ee5 th\u1ec3 c\u1ea3m nh\u1eadn Ca2 +. Kh\u1ea3 n\u0103ng t\u00e1c \u0111\u1ed9ng tr\u00ean ng\u01b0\u1eddi \u0111\u00e3 \u0111\u01b0\u1ee3c kh\u1ea3o s\u00e1t trong m\u1ed9t th\u1eed nghi\u1ec7m l\u00e2m s\u00e0ng nh\u1ecf, c\u00f3 tri\u1ec3n v\u1ecdng, m\u00f9 \u1edf nh\u1eefng ng\u01b0\u1eddi t\u00ecnh nguy\u1ec7n.<\/p>\n

N\u00f3 cho th\u1ea5y r\u1eb1ng ch\u1ebf \u0111\u1ed9 \u0103n GGPP cao (th\u1ecbt b\u00f2, \u0111\u1eadu n\u00e0nh; \u22481.2 \u00b5g m\u1ed7i b\u1eefa \u0103n) l\u00e0m t\u0103ng n\u1ed3ng \u0111\u1ed9 GGPP trong huy\u1ebft t\u01b0\u01a1ng so v\u1edbi ch\u1ebf \u0111\u1ed9 \u0103n ti\u00eau chu\u1ea9n c\u1ee7a ng\u01b0\u1eddi Trung Qu\u1ed1c (0.3 \u00b5g \/ b\u1eefa \u0103n) l\u00ean 1.5 \u0111\u1ebfn 2 v\u00e0 Simvastatin l\u00e0m gi\u1ea3m n\u1ed3ng \u0111\u1ed9 GGPP trong huy\u1ebft t\u01b0\u01a1ng v\u00e0 gi\u1ea3m Ho\u1ea1t \u0111\u1ed9ng c\u1ee7a RhoA trong t\u1ebf b\u00e0o b\u1ea1ch c\u1ea7u \u0111\u01a1n nh\u00e2n trong m\u00e1u (trong \u0111i\u1ec1u ki\u1ec7n thi\u1ebfu oxy). Nh\u01b0 \u0111\u00e3 tr\u00ecnh b\u00e0y tr\u01b0\u1edbc \u0111\u00e2y \u1edf chu\u1ed9t, t\u1ea5t c\u1ea3 c\u00e1c t\u00e1c d\u1ee5ng c\u1ee7a Statin \u0111\u00e3 b\u1ecb lo\u1ea1i b\u1ecf b\u1edfi ch\u1ebf \u0111\u1ed9 \u0103n th\u1ecbt b\u00f2 ho\u1eb7c \u0111\u1eadu t\u01b0\u01a1ng v\u00e0 \u0111\u01b0\u1ee3c ph\u1ee5c h\u1ed3i b\u1eb1ng c\u00e1ch u\u1ed1ng \u0111\u1ed3ng th\u1eddi chi\u1ebft xu\u1ea5t t\u1ecfi Methyl Allylthiosulfinate cao. C\u00e1c nghi\u00ean c\u1ee9u ch\u1ee9a nhi\u1ec1u d\u1eef li\u1ec7u n\u00e0y cung c\u1ea5p m\u1ed9t s\u1ed1 hi\u1ec3u bi\u1ebft m\u1edbi l\u1ea1 quan tr\u1ecdng. Khi nh\u00ecn l\u1ea1i, g\u1ea7n nh\u01b0 \u0111\u00e1ng ng\u1ea1c nhi\u00ean l\u00e0 kh\u00f4ng ai t\u1eebng xem x\u00e9t h\u00e0m l\u01b0\u1ee3ng ch\u1ebf \u0111\u1ed9 \u0103n u\u1ed1ng c\u1ee7a GGPP li\u00ean quan \u0111\u1ebfn li\u1ec7u ph\u00e1p Statin. M\u1ed9t nghi\u00ean c\u1ee9u tr\u01b0\u1edbc \u0111\u00f3 \u0111\u00e3 b\u00e1o c\u00e1o m\u1ee9c GGPP t\u01b0\u01a1ng t\u1ef1 ho\u1eb7c cao h\u01a1n trong g\u1ea1o \u0111\u00e1nh b\u00f3ng (0 \u0111\u1ebfn \u22481000 ng\/g) nh\u01b0ng \u0111\u00e3 li\u00ean k\u1ebft c\u00e1c t\u00ednh ch\u1ea5t n\u00e0y v\u1edbi kh\u1ea3\u00a0 n\u0103ng ch\u1ed1ng ung th\u01b0 c\u00f3 th\u1ec3 c\u00f3 c\u1ee7a GGPP. C\u01a1 ch\u1ebf ho\u1ea1t \u0111\u1ed9ng \u0111\u01b0\u1ee3c \u0111\u01b0a ra c\u1ee7a Statin trong m\u00f4 h\u00ecnh \u0111\u1ed9ng v\u1eadt v\u1edbi PAH v\u00e0 s\u1ef1 \u0111\u1ed1i kh\u00e1ng c\u1ee7a ch\u00fang b\u1edfi GGPP r\u1ea5t ph\u00f9 h\u1ee3p v\u1edbi nghi\u00ean c\u1ee9u tr\u01b0\u1edbc \u0111\u00e2y v\u00e0 m\u1edf r\u1ed9ng \u0111\u00e1ng k\u1ec3 n\u00f3, v\u00ed d\u1ee5, v\u1ec1 vai tr\u00f2 c\u1ee7a th\u1ee5 th\u1ec3 c\u1ea3m nh\u1eadn Rab10 v\u00e0 Ca2 +. \u0110i\u1ec3m m\u1ea1nh c\u1ee7a nghi\u00ean c\u1ee9u n\u00e0y bao g\u1ed3m c\u00e1c quy tr\u00ecnh ph\u00e2n t\u00edch GGPP c\u1ea9n th\u1eadn, s\u1ee9c m\u1ea1nh c\u1ee7a nh\u1eefng hi\u1ec3u bi\u1ebft v\u1ec1 c\u01a1 h\u1ecdc bao g\u1ed3m m\u1ed9t s\u1ed1 ph\u01b0\u01a1ng ph\u00e1p ti\u1ebfp c\u1eadn m\u1ea5t ch\u1ee9c n\u0103ng invitro v\u00e0 invivo, v\u00e0 t\u00ednh nh\u1ea5t qu\u00e1n v\u1ec1 d\u01b0\u1ee3c l\u00fd v\u1edbi n\u1ed3ng \u0111\u1ed9 t\u01b0\u01a1ng t\u1ef1 trong huy\u1ebft t\u01b0\u01a1ng \u1edf chu\u1ed9t v\u00e0 ng\u01b0\u1eddi c\u0169ng nh\u01b0 t\u00e1c d\u1ee5ng th\u1ef1c t\u1ebf c\u1ee7a Statin v\u00e0 ch\u1ebf \u0111\u1ed9 \u0103n \/ GGPP, t\u01b0\u01a1ng \u1ee9ng. T\u1ea5t nhi\u00ean, c\u00e2u h\u1ecfi m\u1edf v\u1eabn c\u00f2n. C\u00e1c hi\u1ec7u qu\u1ea3 \u0111i\u1ec1u tr\u1ecb hi\u1ec7n t\u1ea1i \u1edf chu\u1ed9t v\u1edbi PAH kh\u00f4ng th\u1ec3 \u0111\u01b0\u1ee3c truy\u1ec1n tr\u1ef1c ti\u1ebfp cho b\u1ec7nh nh\u00e2n. Nh\u01b0 c\u00e1c t\u00e1c gi\u1ea3 \u0111\u00e3 tuy\u00ean b\u1ed1 r\u00f5 r\u00e0ng, Statin kh\u00f4ng cho th\u1ea5y hi\u1ec7u qu\u1ea3 \u0111i\u1ec1u tr\u1ecb nh\u1ea5t qu\u00e1n \u1edf b\u1ec7nh nh\u00e2n PAH. Tr\u00ean th\u1ef1c t\u1ebf, s\u1ef1 m\u00e2u thu\u1eabn c\u1ee7a d\u1eef li\u1ec7u l\u00e2m s\u00e0ng l\u00e0 m\u1ed9t l\u00fd do cho nghi\u00ean c\u1ee9u. Li\u1ec1u Simvastatin \u1edf chu\u1ed9t c\u1ed1ng cao h\u01a1n nhi\u1ec1u so v\u1edbi li\u1ec1u \u0111i\u1ec1u tr\u1ecb t\u1ed1i \u0111a \u1edf b\u1ec7nh nh\u00e2n (10 mg\/kg so v\u1edbi t\u1ed1i \u0111a 1 mg\/kg \u1edf b\u1ec7nh nh\u00e2n). Tuy nhi\u00ean, ngay c\u1ea3 li\u1ec1u th\u1ea5p 20 mg Simvastatin c\u0169ng \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn ho\u1ea1t \u0111\u1ed9ng GGPP v\u00e0 RhoA trong nghi\u00ean c\u1ee9u tr\u00ean ng\u01b0\u1eddi, cho th\u1ea5y r\u1eb1ng Statin \u1edf li\u1ec1u ti\u00eau chu\u1ea9n c\u00f3 th\u1ec3 thay \u0111\u1ed5i n\u1ed3ng \u0111\u1ed9 GGPP trong huy\u1ebft t\u01b0\u01a1ng. Sinh kh\u1ea3 d\u1ee5ng ph\u1ea3n \u1ee9ng to\u00e0n th\u00e2n r\u1ea5t th\u1ea5p c\u1ee7a statin (\u2248 5% \u0111\u1ed1i v\u1edbi Simvastatin) cho th\u1ea5y r\u1eb1ng vi\u1ec7c \u1ee9c ch\u1ebf HMG-CoA reductase \u1edf gan l\u00e0m gi\u1ea3m n\u1ed3ng \u0111\u1ed9 Isoprenoids trong huy\u1ebft thanh, nh\u01b0ng \u0111i\u1ec1u n\u00e0y c\u1ea7n ph\u1ea3i ph\u00e2n t\u00edch th\u00eam. Nghi\u00ean c\u1ee9u kh\u00f4ng tr\u1ea3 l\u1eddi li\u1ec7u GGPP trong ch\u1ebf \u0111\u1ed9 \u0103n u\u1ed1ng c\u00f3 \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn hi\u1ec7u qu\u1ea3 c\u1ee7a Statin trong vi\u1ec7c ph\u00f2ng ng\u1eeba c\u00e1c bi\u1ebfn c\u1ed1 tim m\u1ea1ch v\u00e0 c\u00e1c b\u1ec7nh kh\u00e1c hay kh\u00f4ng.<\/p>\n

Nghi\u00ean c\u1ee9u c\u1ee7a Zhu v\u00e0 c\u1ed9ng s\u1ef1 ch\u1ee9ng minh r\u1eb1ng c\u00e1c ch\u1ebf \u0111\u1ed9 \u0103n kh\u00e1c nhau ch\u1ee9a nhi\u1ec1u m\u1ee9c GGPP kh\u00e1c nhau v\u00e0 GGPP trong ch\u1ebf \u0111\u1ed9 \u0103n \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn n\u1ed3ng \u0111\u1ed9 GGPP trong huy\u1ebft t\u01b0\u01a1ng v\u00e0 \u0111i\u1ec1u ch\u1ec9nh t\u00e1c d\u1ee5ng to\u00e0n th\u00e2n c\u1ee7a Statin trong c\u00e1c m\u00f4 h\u00ecnh \u0111\u1ed9ng v\u1eadt c\u00f3 PAH v\u00e0 nh\u00f3m ng\u01b0\u1eddi t\u00ecnh nguy\u1ec7n (ho\u1ea1t \u0111\u1ed9ng RhoA). D\u1eef li\u1ec7u \u0111\u1eb7t ra c\u00e2u h\u1ecfi g\u00e2y t\u00f2 m\u00f2 v\u1ec1 vi\u1ec7c li\u1ec7u c\u00e1c nh\u00f3m d\u00e2n c\u01b0 c\u00f3 ch\u1ebf \u0111\u1ed9 \u0103n \u0111i\u1ec3n h\u00ecnh ch\u1ee9a nhi\u1ec1u \u0111\u1eadu n\u00e0nh ho\u1eb7c th\u1ecbt b\u00f2 \u00edt \u0111\u01b0\u1ee3c h\u01b0\u1edfng l\u1ee3i t\u1eeb statin hay kh\u00f4ng. Nghi\u00ean c\u1ee9u n\u00ean \u0111\u01b0\u1ee3c coi l\u00e0 t\u1ea1o ra gi\u1ea3 thuy\u1ebft v\u00e0 k\u00edch th\u00edch c\u00e1c ph\u00e2n t\u00edch h\u1ed3i c\u1ee9u v\u1ec1 \u0111\u0103ng k\u00fd l\u00e2m s\u00e0ng v\u00e0 c\u00e1c th\u1eed nghi\u1ec7m can thi\u1ec7p l\u1edbn hi\u1ec7n c\u00f3 \u0111\u1ec3 x\u00e1c nh\u1eadn ho\u1eb7c b\u00e1c b\u1ecf gi\u1ea3 thuy\u1ebft n\u00e0y. D\u00f9 k\u1ebft qu\u1ea3 ra sao, nghi\u00ean c\u1ee9u l\u00e0 m\u1ed9t v\u00ed d\u1ee5 ph\u00f9 h\u1ee3p v\u1ec1 c\u01a1 s\u1edf khoa h\u1ecdc k\u1ef9 l\u01b0\u1ee1ng c\u1ee7a ch\u00e2m ng\u00f4n \u0111\u01b0\u1ee3c ph\u1ed5 bi\u1ebfn r\u1ed9ng r\u00e3i r\u1eb1ng ch\u00fang ta l\u00e0 nh\u1eefng g\u00ec ch\u00fang ta \u0103n.<\/p>\n

Ngu\u1ed3n<\/strong>: Statins Do More Than Lower Cholesterol\u2014Depending on What You Eat? by\u00a0 Thomas Eschenhagen and Ulrich Laufs<\/p>\n

 <\/p>\n","protected":false},"excerpt":{"rendered":"

Statins l\u00e0 m\u1ed9t lo\u1ea1i thu\u1ed1c \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ec3 gi\u1ea3m m\u1ee9c \u0111\u1ed9 cholesterol trong m\u00e1u. Cholesterol l\u00e0 m\u1ed9t lo\u1ea1i m\u1ee1 c\u00f3 trong c\u01a1 th\u1ec3 v\u00e0 c\u00f3 vai tr\u00f2 quan tr\u1ecdng trong vi\u1ec7c s\u1ea3n xu\u1ea5t hormone, vitamin D v\u00e0 c\u00e1c ch\u1ea5t b\u00e9o c\u1ea7n thi\u1ebft cho c\u01a1 th\u1ec3. Tuy nhi\u00ean, m\u1ed9t m\u1ee9c \u0111\u1ed9 cholesterol cao c\u00f3 th\u1ec3 […]<\/p>\n","protected":false},"author":4,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[7,33],"tags":[3],"yoast_head":"\nM\u1ee9c \u0111\u1ed9 h\u1ea1 Cholesterol khi d\u00f9ng Statins ph\u1ee5 thu\u1ed9c v\u00e0o ch\u1ebf \u0111\u1ed9 \u0103n?<\/title>\n<meta name=\"description\" content=\"Nghi\u00ean c\u1ee9u c\u1ee7a Zhu v\u00e0 c\u1ed9ng s\u1ef1 \u0111\u00e3ch\u1ee9ng minh r\u1eb1ng c\u00e1c ch\u1ebf \u0111\u1ed9 \u0103n kh\u00e1c nhau ch\u1ee9a nhi\u1ec1u m\u1ee9c GGPP kh\u00e1c nhau v\u00e0 GGPP trong ch\u1ebf \u0111\u1ed9 \u0103n \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn\" \/>\n<meta name=\"robots\" content=\"noindex, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta 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