Statins are widely prescribed to reduce levels of LDL, the “bad cholesterol,” a vital goal in stemming and preventing cardiovascular disease. But they don’t work for everybody, often for inexplicable reasons. Researchers now think some of the blame rests with gut bacteria, that influential yet mysterious group that occupies our bowels and outnumbers our cells 10 to one. In a study published this month in PLoS One, researchers took blood samples from 944 study participants prior to and after six weeks of treatment with a statin called simvastatin. They measured the levels of various bile acids, many of which are produced by gut bacteria and help metabolize fat by acting like detergents, allowing cholesterol to be dissolved and transported in the blood. The researchers found that people whose LDL levels dropped the most had significant quantities of three bile acids produced by a particular type of gut bacteria. Those who responded least to the statins had significantly higher levels of five different bile acids from different gut flora. The researchers hypothesize that bile acids present in the non-responders compete with simvastatin for transporters that ferry both chemicals to the liver, where the drug has its effect.
The cholesterol-lowering drugs known as statins are already one of the most commonly prescribed medications, taken by 15 million Americans in an attempt to ward off heart disease. Now, a new study suggests that the drugs may also reduce the risk of Alzheimer’s and dementia by 50 percent.
While the provocative finding offers hope that the cholesterol-reducing drugs might help against Alzheimer’s disease and other forms of dementia, scientists say this study is unlikely to be the last word on the topic. Indeed, it may just fuel an already lively debate over statins’ potential effect on dementia. Some research has hinted at benefits, while other studies, particularly in people with clear signs of Alzheimer’s disease, show no effect from the drugs [Science News].
The day after the American Academy of Pediatrics recommended prescribing cholesterol-lowering drugs to some 8-year-olds, howls of protest arose from many doctors and parents. While the academy maintains that prescription drugs could help cope with the rising tide of childhood obesity and could prevent children from developing heart disease later in life, many observers say the guidelines send the wrong messages to families.
Some doctors said the recommendation would distract from common-sense changes in diet and exercise, which are also part of the new guidelines. “To be frank, I’m embarrassed for the A.A.P. today,” said Dr. Lawrence Rosen [The New York Times]. Childhood obesity expert David Ludwig adds: “My concern is what this is saying about society when we are so quick to prescribe drugs for these conditions before having systematically attacked the problem from the public health perspective” [The New York Times].
The American Academy of Pediatrics has issued new guidelines that call for testing at-risk children’s cholesterol levels from the age of 2, and advise giving some children cholesterol-lowering drugs from the age of 8 in hopes of preventing heart disease later in life. Writing in the journal Pediatrics, doctors say that the recommendations have taken on “a new urgency, given the current epidemic of childhood obesity.”
The new guidelines are likely to stir the controversy over prescribing long-term medications to children, especially for treating symptoms related to obesity, which can also be treated with diet and exercise. But proponents say there is growing evidence that the first signs of heart disease show up in childhood, and with 30 percent of the nation’s children overweight or obese, many doctors fear that a rash of early heart attacks and diabetes is on the horizon as these children grow up [The New York Times].