Background Cardiovascular disease (CVD) is the worldwide leading cause of death among non-communicable diseases and results in a huge burden of mortality and morbidity. China, a rapidly growing East Asian country, has the world largest population and is facing an increasing burden. Incidence of CVD is lower in China than in Western countries. There are more strokes, especially hemorrhagic strokes, but less coronary heart disease (CHD) in China than in Western countries. Statin, a first-choice drug for lowering low-density lipoprotein cholesterol (LDL-C), has been shown to be effective in preventing CVD and is widely used in Western countries. However, it is not known whether the same can be applied to Asian countries, where the incidence of CVD is lower and ischemic events are rarer. The aim of this systematic review is to evaluate the effectiveness of statin for prevention of CVD in East Asian populations. Methods A systematic review was conducted by searching for randomized controlled trials from 3 databases (PubMed, MEDLINE and Cochrane Trial) for prevention of CVD comparing statin with usual care or placebo in East Asian population. Data on CVD events (deaths, CHD and cerebrovascular events, rehospitalization and revascularization) and serum lipid levels (total cholesterol (TC), LDL-C, high-density lipoprotein cholesterol (HDL-C) and triglycerides (TG)) were extracted. Risk ratios of CVD events and change in serum lipid level were tabulated. The relationship between change in serum lipid level and mortality and incidence of CVD events were also explored. Results Fourteen studies were included, with most of them (9 studies) done in Japan. Overall, statins did not significantly reduce risk of mortality, CHD events, cerebrovascular events, revascularization and rehospitalization due to CHD. However, statins consistently lowered the risk of angina-related rehospitalization by 53% (95% confidence interval (CI) 23% to 71%) and 64% (95% CI 11% to 86%) respectively in 2 studies. There was a consistent reduced risk of composite CVD events by 34% (95% CI 5% to 55%) to 54% (95% CI 6% to 41%) in 4 studies for secondary prevention. In terms of change in lipid levels, TC and LDL-C were significantly reduced by 8% to 31% and 14% to 41% respectively with statin treatment. Change in HDL-C and TG were not consistent across studies. Lowering of TC and LDL-C level was correlated with the reduction in composite CVD and CHD events. Conclusion The use of statins in East Asian populations to prevent CVD may not be as effective as in Western countries, because of the lower baseline risk and different patterns of CVD. As the prevalence of CVD risk factors increases, the incidence of CVD will increase and the pattern of CVD may change, so careful monitoring is needed. More importantly, most of the studies included had small sample sizes, short follow-up periods and/or low methodological quality, which might contribute to the inconsistent findings. A further large-scale randomized controlled trial should be done to confirm the benefits of statins among Chinese. / published_or_final_version / Public Health / Master / Master of Public Health

Not available / text

Simvastatin, a commonly prescribed statin, has exhibited several unexpected non-cholesterol lowering benefits. For example, patients taking statins have a decreased mortality rate due to bactereamia, a systemic bacterial infection commonly caused by Staphylococcus aureus (S. aureus). To investigate statin protection during bactereamia, human umbilical vein endothelial cells (HUVEC) were pre-treated with simvastatin followed by infection with S. aureus, and infection was significantly decreased. Simvastatin inhibits the cholesterol biosynthesis pathway. Therefore, the protective effect of simvastatin may be due to isoprenoid inhibition, specifically, farnesyl pyrophosphate (Fpp) and geranylgeranyl pyrophosphate (GGpp). Fpp and GGpp prenylate small G-proteins that function in cytoskeletal rearrangement and endocytosis. When Fpp and GGpp were replenished, infection was not significantly reduced. Furthermore, when farnesyl transferase and geranylgeranyl transferase, enzymes essential to transfer isoprenoid group during prenylation, were inhibited a significant decrease in infection was observed. The data indicates that Fpp and GGpp are essential for S. aureus infection. / Department of Biology

Staphylococcus aureus, the most prevalant etiologic agent causing sepsis (a damaging inflammatory response), is traditionally cleared with antibiotics. Increased numbers of antibiotic-resistant strains mandate additional treatments to clear infections and prevent sepsis. There is evidence that suggests the lipid-lowering drug simvastatin may be beneficial for treating S. aureus infections due to its anti-inflammatory and immunomodulatory effects. In this study we pretreated 8-13 week old, male and female Balb/c and C57BL/6 mice with 1000 ng/g [BW] simvastatin in ethanol at 18 and 3 hours prior to S. aureus infection. We subsequently administered 10 mg/kg [BW] gentamicin in saline at 3, 6, 12, 24, and 48 hour timepoints. Another group of mice did not receive simvastatin treatment, and the final group received control treatments and was not infected with S. aureus. Our studies demonstrate that simvastatin may down-regulate sepsis-inducing inflammatory responses in S. aureus-infected C57BL/6 mice. / Department of Biology

Thesis (Ph.D.)--University of Western Australia, 2007.

Thesis (Ph. D.)--Chemistry and Biochemistry, Georgia Institute of Technology, 2008. / Committee Co-Chair: Hud, Nicholas; Committee Co-Chair: Radhakrishna, Harish; Committee Member: Doyle, Donald; Committee Member: Fahrni, Christoph; Committee Member: McCarty, Nael. Part of the SMARTech Electronic Thesis and Dissertation Collection.

Dissertation (PhD)--University of Stellenbosch, 2003. / ENGLISH ABSTRACT: The Effect of Statins on Bone and Mineral Metabolism Both statins and amino-bisphosphonates reduce the prenylation of proteins which are involved in cytoskeletal organization and activation of polarized and motile cells. Consequently statins have been postulated to affect bone metabolism. We investigated the effects of different doses of simvastatin (1,5,10 and 20mg/Kg/day), administered orally over 12 weeks to intact female Sprague-Dawley rats, and the effect of simvastatin 20mg/Kg/day in sham and ovariectomised rats, on femoral bone mineral density (BMD) and quantitative bone histomorphometry (QBH), compared to controls. Similarly, the affect of atorvastatin (2,5mg/Kg/day) and pravastatin (10mg/Kg/day) on BMD was investigated and compared to controls. BMD was decreased by simvastatin 1mg/Kg/day (p = 0.042), atorvastatin (p = 0,0002) and pravastatin (p = 0.002). The effect on QBH parameters differed with different doses of simvastatin (ANOVA; p = 0.00012). QBH parameters of both bone formation and resorption were equivalently and markedly increased by simvastatin 20mg/Kg/day in two independent groups of intact rats, and reflected by a relatively unchanged BMD. At lower doses, simvastatin 1mg/Kg/day decreased bone formation while increasing bone resorption as reflected by a marked decrease in BMD. Ovariectomised animals receiving simvastatin 20mg/Kg/day showed no change in BMD relative to the untreated ovariectomised controls, their increase in bone formation was smaller than in sham-operated rats receiving simvastatin and there was no change in bone resorption. The dose response curves of simvastatin for bone formation and resorption differed from each other. From these studies it is concluded that:- a) low-dose simvastatin (1mg/Kg/day), atorvastatin 2.5mg/Kg/day) and pravastatin 10mg/Kg/day) decrease BMD in rodents;b) 1mg/Kg/day simvastatin decreases bone formation and increases bone resorption and is reflected by a reduced BMD; c) 20mg/Kg/day simvastatin increases bone formation and resorption and results in an unchanged BMD; d) the effects of simvastatin on QBH differ at different dosages; e) the dose-response curves for QBH parameters of bone resorption and bone formation differ from each other; f) the effects of simvastatin seen in intact rats are not observed in ovariectomised rats; g) simvastatin is unable to prevent the bone loss caused by ovariectomy. / AFRIKAANSE OPSOMMING: Die Effek van Statiene op Been en Mineraal Metabolisme Beide statiene en aminobisfosfonate verminder die prenelasie van proteïene wat betrokke is in die sitoskeletale organisasie en aktivering van gepolariseerde en beweeglike selle. Gevolglik is dit gepostuleer dat statiene ‘n invloed sal hê op been metabolisme. Ons het die effekte van verskillende dossisse van simvastatien (1, 5, 10 en 20mg/Kg/dag), mondelings toegedien oor 12 weke aan intakte vroulike Sprague-Dawley rotte, en die effek van simvastatien 20mg/Kg/dag op skyn- en ge-ovariektomeerde rotte, op femorale been mineral digtheid (BMD) en kwantitatiewe been histomorfometrie (KBH), vergeleke met kontroles, ondersoek. Op ‘n soortgelyke manier is die effek van atorvastatien (2,5mg/Kg/day) en pravastatien (10mgKg/dag) op BMD ondersoek en vergelyk met kontroles. BMD is verminder deur simvastatien 1mg/Kg/dag (p = 0.042), atorvastatien (p = 0.0002) en pravastatien (p = 0.002). Die effekte op KBH parameters het verskil met verskillende dossisse van simvastatien (ANOVA; p = 0.00012). KBH parameters van beide been vormasie en resorpsie is vergelykend en merkbaar verhoog deur simvastatien 20mg/Kg/dag in twee onafhanklike groepe van intakte rotte en is vergesel deur ‘n relatiewe onveranderde BMD. Met laer dossisse het simvastatien 1mg/Kg/dag been vormasie verminder terwyl been resorpsie verhoog is en is weerspieël deur ‘n merkbaar verminderde BMD. Ge-ovariektomeerde diere wat simvastatien 20mg/Kg/dag ontvang het, het geen verandering in BMD relatief tot die onbehandelde geovariektomeerde kontroles getoon nie, en die toename in been vormasie was kleiner as in die skyngeopereerde rotte wat simvastatien ontvang het en daar was geen verandering in been resorpsie nie. Die dosis-respons kurwes vir simvastatien vir been vormasie en resorpsie het van mekaar verskil. Uit hierdie studies word die volgende gevolgtrekkings gea) lae-dosis simvastatien (1mg/Kg/dag), atorvastatien 2.5mg/Kg/dag en pravastatien 10mg/Kg/dag verminder BMD in knaagdiere; b) 1mg/Kg/dag simvastatien verminder been vormasie en verhoog been resorpsie en veroorsaak gevolglik ‘n velaging in die BMD; c) 20mg/Kg/dag simvastatien verhoog been vormasie en resorpsie met ‘n gevolglike onveranderde BMD; d) die effekte van simvastatien op KBH verskil met verskillende dossisse; e) die dosis-repons kurwes van been resorpsie en been vormasie veskil van mekaar f) die effekte van simvastatien wat waargeneem in intakte rotte word nie gesien in ge-ovariektomeerde rotte nie; g) simvastatien kannie die verlies van been wat veroorsaak word deur ovariektomie voorkom nie.

Cheung, Chi Yun. / "September 2011." / Thesis (M.Phil.)--Chinese University of Hong Kong, 2011. / Includes bibliographical references (leaves 57-59). / Abstracts in English and Chinese. / Acknowledgment --- p.i / Table of Contents --- p.ii / Abstract --- p.iii / Abstract (Chinese Version) --- p.iv / Abbreviation --- p.v / Chapter 1. --- Introduction --- p.1 / Chapter 1.1 --- General Background --- p.1 / Chapter 1.2 --- Mechanism of action --- p.3 / Chapter 1.2.1 --- Biosynthetic pathway of cholesterol --- p.3 / Chapter 1.2.2 --- Inhibition of HMG-CoA reductase by statins --- p.4 / Chapter 1.2.3 --- Plasma cholesterol reduction effect --- p.5 / Chapter 1.3 --- Previous syntheses of statin analogs --- p.5 / Chapter 1.3.1 --- Synthesis from (S)-malic acid --- p.6 / Chapter 1.3.2 --- Synthesis via enantioselective deprotonation --- p.7 / Chapter 1.3.3 --- Synthesis via asymmetric Diels-Alder reaction --- p.9 / Chapter 2. --- Results and Discussion --- p.11 / Chapter 2.1 --- Approaches towards construction of statin analogs --- p.11 / Chapter 2.2 --- Attempt to synthesize alkene 49 from D-arabinose --- p.12 / Chapter 2.3 --- Construction of alkene 49 from D-mannitol --- p.14 / Chapter 2.4 --- Olefin metathesis and conversion to statin analogs --- p.28 / Chapter 3. --- Conclusion --- p.32 / Chapter 4. --- Experimental Section --- p.33 / Chapter 5. --- References --- p.57 / Chapter 6. --- Appendix ii --- p.60

Thesis (M.S.)--Ball State University, 2009. / Title from PDF t.p. (viewed on Nov. 30, 2009). Includes bibliographical references (p. 74-80).

LPA1 lysophosphatidic acid receptors (LPA1Rs) are normally present on the surface of the cell. Our initial findings were that HMG-CoA reductase inhibitors (atorvastatin and mevastatin) induce the sequestration of the G protein-coupled LPA1R in recycling endosomes, most likely by inhibiting the recycling of tonically internalized receptors. Whereas, co-addition of geranylgeranylpyrophosphate (GGPP) or geranylgeraniol (GGOH) prevented atorvastatin-induced sequestration of LPA1Rs, the geranylgeranyltransferase-I inhibitor, GGTI-298, mimicked atorvastatin and induced LPA1R sequestration. This suggested that statin-induced endosomal sequestration was caused by defective protein prenylation. The likely targets of atorvastatin and GGTI-298 are the Rho family GTPases, RhoC and RhoA, since both inhibitors greatly reduced the abundance of these GTPases and since knockdown of endogenous RhoC or RhoA with small interfering RNAs (siRNAs) led to endosomal sequestration of LPA1R. Knockdown of RhoC was much more potent at inducing endosomal sequestration than knockdown of either RhoA or RhoB. In contrast, atorvastatin, GGTI-298, siRNA against RhoA, B, or C did not alter the internalization or recycling of transferrin receptors, indicating that recycling of transferrin receptors is distinct from LPA1Rs. Thus, these results, for the first time, implicate RhoA and RhoC in endocytic recycling of LPA1Rs and identify atorvastatin and GGTI-298 as novel inhibitors of this process. / Per the request of the author and advisor, and with the approval of the Graduate Education office, the following changes were made to this thesis: Replaced original page 1 with Errata Page 2. Replaced original pages 3-28 with Errata Pages 3 – 16. Replaced original pages 69-71 with Errata pages 17 – 19.