JCEM：湘雅二院赵水平等研究发现辅酶A可有效降低血浆甘油三脂水平

为了评估在伴有中度血脂异常的中国患者，天然降血脂化合物辅酶A（CoA）的降脂疗效和临床安全性，来自中南大学湘雅二院心脏科的赵水平教授及其团队进行了一项研究，该研究发现CoA可有效降低血浆甘油三脂（TG）水平，并且没有明显的不良反应。该研究发表在2013年2月的美国《临床内分泌代谢杂志》（The journal of clinical endocrinology & metabolism）上。

该研究中共有244例伴有中度血脂异常（TG，2.3–6.5mmol/l）的受试者（170例男性和74例女性，年龄18–75岁），随机分成3组，分别使用安慰剂（组A，81例）、CoA 200U/d(组B，79例)和CoA 400U/d（组C，84例）。在基线和治疗4周、8周后测量脂蛋白，肝和肾功能，血糖和全血细胞计数。

该研究结果表明，在治疗4周后，A、B和C组TG分别降低5.1%，15.7%和14.4%。治疗8周后，A、B和C组TG分别降低0.9%，21.7%和36.1%。与A组相比，B组和C组的主要疗效结果TG显著降低（P＜0.01），并且，B组和C组之间的差异也有意义（P＜0.01）。血浆总胆固醇、低密度脂蛋白胆固醇和高密度脂蛋白胆固醇没有显著差异。此外，3组之间的血糖，肝和肾功能检验参数，肌病发生率或者胃肠道症状没有差异。

该研究发现，在中度血脂异常的个体，CoA可有效降低血浆TG水平，并且没有明显不良反应。

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The effects of coenzyme A on serum lipids in patients with hyperlipidemia: results of a multicenter clinical trial.
OBJECTIVES
The aim of the study was to evaluate the lipid-lowering effects and clinical safety of a natural hypolipidemic compound, coenzyme A (CoA) capsule, in Chinese patients with moderate dyslipidemia.
METHODS
A total of 244 subjects (170 males and 74 females; aged 18-75 y) having moderate dyslipidemia (triglyceride [TG], 2.3-6.5 mmol · L(-1)) were randomly divided into 3 groups, to which placebo (group A, n = 81), CoA 200 U/d (group B, n = 79), and CoA 400 U/d (group C, n = 84) were administered, respectively. Blood lipoproteins, liver and renal functions, blood glucose, and complete blood count were measured at the baseline and after 4 or 8 weeks of treatment.
RESULTS
After treatment for 4 weeks, TG was reduced by 5.1, 15.7, and 14.4% in groups A, B, and C, respectively. After treatment for 8 weeks, TG decreased .9, 21.7, and 36.1%, respectively. Compared with group A, the primary efficacy outcome TG in groups B and C significantly decreased (P < .01), and the difference between groups B and C was also significant (P < .01). Plasma total cholesterol, low-density lipoprotein cholesterol, and high-density lipoprotein cholesterol were not significantly different. Furthermore, there was no difference in blood glucose, hepatic and renal function test parameters, incidence of myopathy, or gastrointestinal tract symptoms among the 3 groups.
CONCLUSION
CoA can effectively reduce plasma TG levels in subjects with moderate dyslipidemia and has no obvious adverse effect.