CYP3A4*1G polymorphism is associated with lipid-lowering efficacy of atorvastatin but not of simvastatin

Purpose Our aim was to observe the impact of CYP3A4*1G genetic polymorphism on lipid-lowering efficacy of statins. Methods We studied 217 unrelated hyperlipidemic patients who prospectively received atorvastatin and 199 patients who received simvastatin as a single-agent therapy (20 mg day(-1) p.o.) for 4 weeks. Genotyping of CYP3A4*1G was conducted by a polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) analysis. Serum triglyceride (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C) levels were determined before and after treatment by enzymatic assays. Results The frequency of CYP3A4*1G in Chinese hyperlipidemic patients was 0.276. After atorvastatin treatment, the mean percentage reduction in serum TC was 16.8 +/- 3.3% (*1/*1), 17.8 +/- 3.8% (*1/*1G), and 20.9 +/- 5.0% (*1G/*1G), respectively. The CYP3A4*1G polymorphism had a gene-dose-dependent effect on percentage reduction in serum TC (P < 0.01). Conversely, there was no significant association between lipid-lowering efficacy of simvastatin and CYP3A4*1G polymorphism. Conclusions Carrying CYP3A4*1G increase the lipid-lowering efficacy of atorvastatin and may have no significant effect on simvastatin treatment.