11.4 : 脂質低下薬: スタチンとその他の薬剤

Hyperlipidemia is a condition characterized by elevated cholesterol and triglycerides in the blood. If untreated, it can lead to serious complications such as atherosclerosis, heart blockage, and pancreatitis.

Statins such as atorvastatin, simvastatin, and rosuvastatin, are commonly prescribed for treatment.

Statins inhibit HMG-CoA reductase, an enzyme involved in cholesterol biosynthesis, reducing intracellular cholesterol levels. Low cholesterol enhances the synthesis of LDL receptors on liver cells and promotes exogenous cholesterol uptake by the receptors.

Statins are well-absorbed orally and metabolized extensively in the liver.

Common side effects include muscle pain, elevated liver enzymes, and, rarely, muscle damage.

Other lipid-lowering drugs include bile acid-binding resins, which reduce LDL reabsorption in the intestines and increase bile excretion, prompting cholesterol to bile conversion in hepatocytes.

Fibrates and niacin reduce very low-density lipoproteins and raise high-density lipoprotein levels.