J Clin Pharmacol
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CLINICAL STUDIES

High-Dose Statin Treatment Does Not Alter Plasma Marker for Brain Cholesterol Metabolism in Patients With Moderately Elevated Plasma Cholesterol Levels

Karin M. Thelen, MS, Reijo Laaksonen, MD, PhD, Hannu Päivä, MD, Terho Lehtimäki, MD, PhD and Dieter Lütjohann, PhD

From the Department of Clinical Pharmacology, University of Bonn, Germany (Ms Thelen, Dr Lütjohann); Department of Internal Medicine (Dr Päivä) and Laboratory of Atherosclerosis Genetics, Department of Clinical Chemistry, Centre for Laboratory Medicine, University Hospital of Tampere and Medical School, University of Tampere, Tampere, Finland (Dr Laaksonen, Dr Lehtimäki); and the Department of Neurology, Erasme Hospital, Free University of Brussels, Belgium (Dr Laaksonen).

Statins inhibit endogenous cholesterol synthesis, up-regulate low-density lipoprotein (LDL) receptor expression in mammalian liver cells, and thus decrease circulating LDL-cholesterol concentrations. As cholesterol seems to play a role in the development of neurodegenerative diseases, it is of interest to evaluate the effect of high dosages of statins (eg, atorvastatin or simvastatin) on brain cholesterol metabolism. Plasma samples from 44 participants (aged 30-69 years, 16 men and 18 women) of an earlier randomized, placebo-controlled, double-blind trial, who took 40 mg atorvastatin or 80 mg simvastatin daily for 2 months, were used to analyze total cholesterol, its precursor lathosterol, and its metabolites 24(S)-hydroxycholesterol and 27-hydroxycholesterol. Despite a significant decrease in absolute plasma concentrations of oxysterols, total cholesterol, and its endogenous synthesis rate, indicated by a decreased ratio of lathosterol to cholesterol, the plasma 24(S)-hydroxycholesterol to cholesterol ratio, a surrogate marker of brain cholesterol homeostasis, remained unchanged. Short-term high-dose atorvastatin and simvastatin treatment does not seem to influence brain cholesterol metabolism in patients with moderately elevated plasma cholesterol levels.

Key Words: Brain cholesterol • statins • lathosterol • 24S-hydroxycholesterol • 27-hydroxycholesterol

Address for reprints: Dieter Lütjohann, PhD, Department of Clinical Pharmacology, University of Bonn, Sigmund-Freud-Str. 25, D-53105 Bonn, Germany; e-mail: dieter.luetjohann{at}ukb.uni-bonn.de.






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