Atorvastatin lowers C-reactive protein and improves endothelium-dependent vasodilation in type 2 diabetes mellitus.

Abstract

Endothelial dysfunction is frequently found in diabetic subjects. This study was performed to investigate whether atorvastatin therapy was able to reverse endothelial dysfunction in type 2 diabetes and, if so, whether the effect was due to its antiinflammatory action. Eighty patients (baseline low density lipoprotein, 4.37 +/- 0.71 mmol/liter) were randomized to atorvastatin (10 mg daily for 3 months, followed by 20 mg daily for 3 months) or placebo in a double blind study. Endothelial function was assessed by high resolution vascular ultrasound, and high sensitivity C-reactive protein (CRP) was assessed by immunoturbidimetric assay. Diabetic patients had higher CRP (P < 0.01) than matched nondiabetic controls, and both endothelium-dependent and independent vasodilation were impaired (P < 0.01). Atorvastatin (10 and 20 mg) lowered plasma cholesterol by 32.9% and 38.0%, triglyceride by 15.4% and 23.1%, and low density lipoprotein by 43.4% and 50.1%, respectively. At 6 months, plasma CRP decreased in the atorvastatin group compared with baseline (P < 0.05). Endothelium-dependent vasodilation improved in the atorvastatin group compared with the placebo group (P < 0.05). The percent change in endothelium-dependent vasodilation at 6 months correlated with the percent change in CRP (r = -0.44; P < 0.05), but not with changes in plasma lipids. In conclusion, treatment with atorvastatin in type 2 diabetes led to a significant improvement in endothelium-dependent vasodilation, which might be partly related to its anti-inflammatory effect.

• Authors: K C B Tan, W S Chow, S C F Tam, V H G Ai, C H L Lam, K S L Lam
• Journal: The Journal of clinical endocrinology and metabolism (J Clin Endocrinol Metab) Vol. 87 Issue 2 Pg. 563-8 (Feb 2002) ISSN: 0021-972X [Print] United States
• PMID: 11836286 (Publication Type: Clinical Trial, Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)

Chemical References

• Anti-Inflammatory Agents
• Anticholesteremic Agents
• Heptanoic Acids
• Pyrroles
• Triglycerides
• C-Reactive Protein
• Cholesterol
• Atorvastatin

Topics

• Anti-Inflammatory Agents (therapeutic use)
• Anticholesteremic Agents (therapeutic use)
• Atorvastatin
• C-Reactive Protein (analysis, antagonists & inhibitors)
• Cholesterol (blood)
• Diabetes Mellitus, Type 2 (diagnostic imaging, drug therapy, physiopathology)
• Double-Blind Method
• Endothelium, Vascular (diagnostic imaging, drug effects, physiopathology)
• Female
• Heptanoic Acids (therapeutic use)
• Humans
• Male
• Middle Aged
• Pyrroles (therapeutic use)
• Reference Values
• Triglycerides (antagonists & inhibitors, blood)
• Ultrasonography
• Vasodilation (drug effects)