Statin therapy response is highly variable. Variants of lipid metabolism genes and statin pharmacokinetic modulators could play a role, however, the impact of most of these variants remains unconfirmed. A prospective and multicenter study included 252 patients was carried out in order to assess, according to achievement of LDL-C or non-HDL-C therapeutic targets and quantitative changes in lipid profiles, the impact of CETP, ABCA1, CYP2D6, and CYP2C9 gene candidate variants on the simvastatin, atorvastatin, and rosuvastatin response. Patients carrier ABCA1 rs2230806 and CYP2D6*3 variants are less likely to achieve therapeutic lipid targets (p = 0.020, OR = 0.59 [0.37, 0.93]; p = 0.040, OR = 0.23 [0.05, 0.93], respectively). Among CETP variants, rs708272 was linked to a 10.56% smaller reduction in LDL-C with rosuvastatin (95% CI = [1.27, 19.86] %; p = 0.028). In contrast, carriers of rs5882 had a 13.33% greater reduction in LDL-C (95% CI = [25.38, 1.28]; p = 0.032). If these findings are confirmed, ABCA1, CYP2D6, and CETP genotyping could be used to help predict which statin and dosage is appropriate in order to improve personalized medicine.

他汀类药物疗法的反应是高度可变的。脂质代谢基因和他汀类药物代谢动力学调节剂的变体可能起作用，但是，大多数这些变体的影响仍未得到证实。进行了一项前瞻性和多中心研究，纳入252名患者，以便根据LDL-C或非HDL-C治疗目标的实现情况和脂质分布的定量变化评估CETP，ABCA1，CYP2D6和CYP2C9基因的影响辛伐他汀，阿托伐他汀和瑞舒伐他汀应答的候选变体。携带ABCA1 rs2230806和CYP2D6 * 3变异体的患者不太可能达到治疗性脂质靶标（p  = 0.020，OR = 0.59 [0.37，0.93]; p 分别为0.040或OR = 0.23 [0.05、0.93]。在CETP变体中，rs708272与瑞舒伐他汀降低LDL-C减少10.56％有关（95％CI = [1.27，19.86]％；p  = 0.028）。相反，rs5882的携带者的LDL-C降低幅度增加了13.33％（95％CI = [25.38，1.28]；p  = 0.032）。如果这些发现得到证实，ABCA1，CYP2D6和CETP基因分型可以用来帮助预测哪种他汀类药物和合适的剂量以改善个性化药物。