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Abstract
Considering metabolic syndrome (MS) as a pathophysiological condition characterized by arterial hypertension, central obesity, insulin resistance, dyslipidemia, and hyperglycemia, this study aims to compare the use of statins and nicotinic acid in the treatment of MS. To this end, a comparative analysis based on relevant clinical and epidemiological studies was conducted. Thus, it is observed that statins significantly reduce LDL cholesterol by about 50% and decrease the risk of cardiovascular events by 25% to 35%, with an odds ratio (OR) of improvement between 0.70 and 0.80. Statins are widely available and accessible, especially in generic versions, and have a relatively manageable adverse effect profile. In contrast, nicotinic acid reduces LDL cholesterol by 15% to 25%, increases HDL cholesterol, and reduces triglycerides, but with less consistent efficacy in preventing cardiovascular events (OR ranging from 0.90 to 1.10) and significant side effects, such as skin flushing and hepatotoxicity. The cost and availability of nicotinic acid are more limited compared to statins. It is concluded that statins are the preferred choice for the treatment of MS due to their robust efficacy and accessibility, while nicotinic acid may be considered in specific cases, with caution due to its adverse effects.
References
ALVAREZ-JIMENEZ, L. et al. Effects of Statins on Fat Oxidation Improvements After Aerobic Exercise Training. The Journal of Clinical Endocrinology and Metabolism, v. 108, n. 5, p. e139–e147, 17 nov. 2022.
DE ALMEIDA VITERBO, C. et al. ASSOCIAÇÃO ENTRE SÍNDROME METABÓLICA E RIGIDEZ ARTERIAL. Revista Brasileira de Hipertensão, v. 30, n. 3, p. 367–373, 30 out. 2023.
DJADJO, Soraya; BAJAJ, Tushar. Niacin. StatPearls, Florida, 2019.
EMHJ. Incidence of and factors associated with metabolic syndrome, south-east Islamic Republic of Iran. Disponível em: <https://www.emro.who.int/emhj-volume-27-2021/volume-27-issue-12/incidence-of-and-factors-associated-with-metabolic-syndrome-south-east-islamic-republic-of-iran.html>.
ESTRELA, C. Metodologia Científica: Ciência, Ensino, Pesquisa. Porto Alegre: Editora Artes Médicas, 2018.
FALUDI, A. A., et al. Diretriz Brasileira de Dislipidemias e Prevenção da Aterosclerose. Arquivos Brasileiros de Cardiologia, v. 109, n. 1, p. 1-76, 2017. doi: 10.5935/abc.20170145.
GERMAN, Charles; LIAO, James. Understanding the molecular mechanisms of statin pleiotropic effects. Archives of Toxicology, v. 97, n. 6, p. 1529–1545, abr. 2023.
GRUNDY, S. M. et al. Implications of recent clinical trials for the National Cholesterol Education Program Adult Treatment Panel III Guidelines. Circulation, v. 110, n. 2, p. 227-239, 2004.
GUIMARÃES, B. C. de S. et al. Evidências sobre a redução do colesterol de lipoproteínas de baixa densidade com outras drogas além de estatinas e inibidores de PCSK6. Brazilian Journal of Health Review, v. 5, n. 3, p. 9630–9644, 17 mai. 2022.
GUYTON, J. R.; BAYS, H. E. Safety considerations with niacin therapy. American Journal of Cardiology, v. 99, n. 6A, p. 22C-31C, 2007.
HUANG, P. L. A comprehensive definition for metabolic syndrome. Disease Models & Mechanisms, v. 2, n. 5-6, p. 231–237, 30 abr. 2009.
KASSI, E. et al. Metabolic syndrome: definitions and controversies. BMC Medicine, v. 9, n. 1, 5 maio 2011.
KATZUNG, Bertram; VANDERAH, Todd. Farmacologia básica e clínica. 15ª ed. McGraw-Hill Education, 2023.
KUANG, Yu-Lin. et al. Identifying genetic modulators of statin response using subject-derived lymphoblastoid cell lines. Pharmacogenomics, v. 22, n. 7, p. 413–421, mai. 2021.
MINISTÉRIO DA SAÚDE. Protocolo Clínico e Diretrizes Terapêuticas - Hipercolesterolemia. Brasília: Ministério da Saúde, 2020. Disponível em: <http://conitec.gov.br/images/Consultas/Relatorios/2020/Relatorio_PCDT_Hipercolesterolemia.pdf>.
ORSI, Fernanda; CANNEGIETER, Suzanne; LIJFERING, Willem. Statin Therapy to Revert Hypercoagulability and Prevent Venous Thromboembolism: A Narrative Review. Seminars in Thrombosis and Hemostasis, v. 45, n. 08, p. 825–833, mai. 2019.
OVCHINNIKOV, Artem et al. Use of Statins in Heart Failure with Preserved Ejection Fraction: Current Evidence and Perspectives. International Journal of Molecular Sciences, v. 25, n. 9, p. 4958–4958, mai. 2024.
OLIVEIRA, L. V. A. et al. Prevalência da Síndrome Metabólica e seus componentes na população adulta brasileira. Ciência & Saúde Coletiva, v. 25, n. 11, p. 4269–4280, 1 nov. 2020.
PARK, S. et al. Comprehensive lifestyle modification interventions for metabolic syndrome: A systematic review and meta‐analysis. Journal of Nursing Scholarship, 27 nov. 2023.
PEREIRA, A. S. et al. Metodologia da pesquisa científica. Santa Maria: UAB/NTE/UFSM, 2018.
PIRES BRANDÃO, A. A., et al. Diretrizes Brasileiras de Dislipidemias. Arquivos Brasileiros de Cardiologia, v. 84, supl. 6, p. 1-80, 2005. doi: 10.1590/S0066-782X2005002400001.
RAMADAS, Amutha et al. Dietary intake, obesity, and metabolic risk factors among children and adolescents in the SEACO-CH20 cross-sectional study. Scientific Reports, v. 14, n. 1, 17 maio 2024.
RAY, Saumitra. Role of statins in the management of dyslipidaemia. Indian Heart, v. 76, Suppl 1, p. S33-S37, mar. 2024.
SAKLAYEN, M. G. The Global Epidemic of the Metabolic Syndrome. Current Hypertension Reports, v. 20, n. 2, 26 fev. 2018.
SANTOS, C.; SCHRANK, Y.; KUPFER, R. Análise crítica dos critérios da OMS, IDF e NCEP para síndrome metabólica em pacientes portadores de diabetes melito tipo 1. Arq Bras Endocrinol Metab, v. 53, n. 9, p. 1096–1102, 2009.
SANTOS, T. L. et al. Aortic stenosis and cardiovascular risk in patients with Homozygous Familial Hypercholesterolemia: a scoping review. Research, Society and Development, v. 11, n. 14, 19 out. 2022.
SOROUT, J.; KACKER, S.; SABOO, N. Síndrome metabólica e possíveis tratamentos (terapias consecutivas): uma revisão de literatura. Revista Internacional de Endocrinologia, v. 18, n. 6, p. 351–357, 2022. https://doi.org/10.22141/2224-0721.18.6.2022.1206.
STONE, N. J. et al. 2013 ACC/AHA Guideline on the Treatment of Blood Cholesterol to Reduce Atherosclerotic Cardiovascular Risk in Adults: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. Journal of the American College of Cardiology, v. 63, n. 25 Pt B, p. 2889-2934, 2014.
TONG, Limin. et al. Clinical Analysis of Atorvastatin Calcium, Fenofibrate, and Acipimox in the Treatment of Hypertriglyceridemia-induced Acute Pancreatitis. Alternative Therapies in Health and Medicine, p. AT9874, 22 mar. 2024.
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