Moa of statins
Pro Research Analysisby 
Searched over 200M research papers
Consensus Meter
Mechanism of Action of Statins
Introduction to Statins and Their Primary Function
Statins are a class of medications widely prescribed to treat dyslipidemia by lowering cholesterol levels in the blood. They achieve this by inhibiting the enzyme 3-β-hydroxy-3β-methylglutaryl Coenzyme A reductase (HMGR), which is the rate-limiting enzyme in the mevalonate (MVA) pathway. This pathway is crucial for the synthesis of cholesterol and other important biological compounds.
Inhibition of HMGR and Cholesterol Synthesis
The primary mechanism of action of statins involves the inhibition of HMGR. By blocking this enzyme, statins effectively reduce the synthesis of mevalonate, a precursor in the cholesterol biosynthesis pathway. This leads to a decrease in the production of cholesterol within the liver, which in turn lowers the levels of low-density lipoprotein (LDL) cholesterol in the bloodstream.
Pleiotropic Effects Beyond Cholesterol Lowering
While the primary function of statins is to lower cholesterol, they also exhibit several pleiotropic effects due to their impact on the MVA pathway. This pathway produces various compounds essential for numerous biological activities, including those in the central nervous system. As a result, statins have been shown to influence brain processes and have potential therapeutic effects in various neurological conditions.
Impact on Lipoprotein(a) Levels
Research has investigated the effects of different types and dosages of statins on lipoprotein(a) [Lp(a)] levels. A network meta-analysis of 20 randomized controlled trials involving 23,605 participants found that statins generally do not have a clinically significant effect on Lp(a) levels. There was no significant difference in the impact on Lp(a) levels between different types and dosages of statins. However, moderate-intensity pitavastatin showed a tendency to reduce Lp(a) levels, although this effect was not statistically significant.
Conclusion
Statins primarily function by inhibiting HMGR, leading to reduced cholesterol synthesis and lower LDL cholesterol levels. Beyond their lipid-lowering effects, statins also exhibit pleiotropic actions that may influence various biological processes, including those in the brain. However, their impact on Lp(a) levels appears to be minimal and not clinically significant. Further research is needed to fully understand the broader implications of statin therapy, particularly in the context of neurological diseases and other non-lipid-related conditions.
Sources and full results
Most relevant research papers on this topic