A new study published in The Journal of Nutrition provides evidence that lipid-lowering drugs may alter blood concentrations of certain vitamins and minerals.
Statins are one of the most frequently prescribed drugs, and their benefits in treating cardiovascular disease are well established. Like many therapeutic agents, statins are not without secondary effects such as muscle weakness and increased risk of type 2 diabetes. In addition, a full understanding of lipid-lowering drug impacts on blood concentrations of vitamins and minerals (micronutrients) remains limited and inconclusive. To bridge this knowledge gap, Wan-Qiang Lv (School of Basic Medical Science, Central South University) and colleagues examined the potential relations of lipid-lowering drug targets and overall lower LDL cholesterol on 15 blood micronutrients.
Using available genetic data, researchers conducted Mendelian randomization analyses to explore gene variants associated with molecular targets of LDL cholesterol-lowering therapies. The Mendelian randomization approach selects genetic variants associated with an exposure to make a causality inference about how change exposure alters outcome risk. As the alleles of special exposure-associated genotypes are assigned at conception, the result of the Mendelian randomization approach may not be influenced by residual confounding biases and reverse causation.
Genetically proxied inhibition of 3-hydroxy-3-methylglutaryl coenzyme A (an enzyme involved in the synthesis of cholesterol, which is a target of statins), lowered blood concentrations of iron, zinc, magnesium, and potassium. Genetically proxied inhibition of Niemann-Pick C1-Like 1 (a protein that mediates intestinal cholesterol absorption, which is a target of the lipid-lowering drug Ezetimibe), increased calcium and vitamin A levels. And, genetically proxied inhibition of PCSK9 protein, which controls the number of low-density lipoprotein receptors, was found to increase vitamin D.
The results of this Mendelian randomization study demonstrate that genetic polymorphisms associated with lower LDL cholesterol are associated with higher blood levels of vitamins D and A. Using genetic proxies for lipid-lowering drug targets, statin and other lipid-lowering treatments may alter blood levels of certain nutrients.
Jing-Yang He, Xue Zhang, Kui Wang, Wan-Qiang Lv, Associations between Genetically Proxied Inhibition of Lipid-Lowering Drug Targets and Serum Micronutrients among Individuals of European Descent: A Mendelian Randomization Study, The Journal of Nutrition, Volume 152, Issue 5, May 2022, Pages 1283–1290, https://doi.org/10.1093/jn/nxac012.
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