Catabolism of HDL particles is accelerated in
type 2 diabetes, leading to a reduction in plasma residence time, which may be detrimental.
Rosuvastatin is the most powerful
statin to reduce
LDL-cholesterol, but its effects on HDL metabolism in
type 2 diabetes remain unknown. We performed a randomized double-blind cross-over trial of 6-week treatment period with placebo or
rosuvastatin 20 mg in eight patients with
type 2 diabetes. An in vivo kinetic study of HDL-
apolipoprotein A-I (
apoA-I) with (13)C
leucine was performed at the end of each treatment period. Moreover, a similar kinetic study was carried out in eight nondiabetic normolipidemic controls.
Rosuvastatin significantly reduced plasma
LDL-cholesterol (-51%),
triglycerides (TGs) (-38%), and HDL-TG (-23%). HDL-
apoA-I fractional catabolic rate (FCR) was decreased by
rosuvastatin (0.25 +/- 0.06 vs. 0.32 +/- 0.07 pool/day, P = 0.011), leading to an increase in plasma HDL-
apoA-I residence time (4.21 +/- 1.02 vs. 3.30 +/- 0.73 day, P = 0.011). Treatment with
rosuvastatin was associated with a concomitant reduction of HDL-
apoA-I production rate. The decrease in HDL-
apoA-I FCR, induced by
rosuvastatin, was correlated with the reduction of plasma TGs and HDL-TG. HDL
apoA-I FCR and production rate values in diabetic patients on
rosuvastatin were not different from those found in controls.
Rosuvastatin is responsible for a 22% reduction of HDL-
apoA-I FCR and restores to normal the increased HDL turnover observed in
type 2 diabetes. These kinetic modifications may have beneficial effects by increasing HDL plasma residence time.