The Interplay of Sirtuin-1, LDL-Cholesterol, and HDL Function: A Randomized Controlled Trial Comparing the Effects of Energy Restriction and Atorvastatin on Women with Premature Coronary Artery Disease

• Main Authors: Dalila Pinheiro Leal (Author), Gustavo Henrique Ferreira Gonçalinho (Author), Thauany Martins Tavoni (Author), Karen Lika Kuwabara (Author), Ana Paula Paccanaro (Author), Fatima Rodrigues Freitas (Author), Célia Maria Cassaro Strunz (Author), Luiz Antonio Machado César (Author), Raul Cavalcante Maranhão (Author), Antonio de Padua Mansur (Author)
• Format: Book
• Published: MDPI AG, 2022-11-01T00:00:00Z.
• Subjects: article
• Online Access: Connect to this object online.
• Notes: 10.3390/antiox11122363; 2076-3921
• Keywords: atherosclerosis; coronary artery disease; HDL; oxidation; atorvastatin; calorie restriction; Therapeutics. Pharmacology; RM1-950
• Source: Antioxidants, Vol 11, Iss 12, p 2363 (2022)

Introduction: HDL function has gained prominence in the literature as there is a greater predictive capacity for risk in early coronary artery disease when compared to the traditional parameters. However, it is unclear how dietary energy restriction and atorvastatin influence HDL function. Methods: A randomized controlled trial with 39 women with early CAD divided into three groups (n = 13): energy restriction (30% of VET), atorvastatin (80 mg), and control. Analyses of traditional biochemical markers (lipid and glucose profile), circulating Sirt-1, and HDL function (lipid composition, lipid transfer, and antioxidant capacity). Results: Participants' mean age was 50.5 ± 3.8 years. Energy restriction increased Sirt-1 by 63.6 pg/mL (95%CI: 1.5-125.7; <i>p</i> = 0.045) and reduced BMI by 0.8 kg/m² (95%CI: −1.349-−0.273; <i>p</i> = 0.004) in a manner independent of other cardiometabolic factors. Atorvastatin reduced LDL-c by 40.0 mg/dL (95%CI: −69.910-−10.1; <i>p</i> = 0.010). Increased Sirt-1 and reduced BMI were independently associated with reduced phospholipid composition of HDL (respectively, β = −0.071; CI95%:−0.136-−0.006; <i>p</i> = 0.033; β = 7.486; CI95%:0.350-14.622; <i>p</i> = 0.040). Reduction in BMI was associated with lower HDL-free cholesterol (β = 0.818; CI95%:0.044-1.593; <i>p</i> = 0.039). LDL-c reduction by statins was associated with reduced maximal lipid peroxide production rate of HDL (β = 0.002; CI95%:0.000-0.003; <i>p</i> = 0.022) and total conjugated diene generation (β = 0.001; CI95%:0.000-0.001; <i>p</i> = 0.029). Conclusion: This study showed that energy restriction and atorvastatin administration were associated with changes in lipid profile, serum Sirt-1 concentrations, and HDL function.