Tanaka A, Yamada N, Saito Y, Kawakami M, Ohashi Y, Akanuma Y
Third Department of Internal Medicine, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, 113-8519, Tokyo, Japan.
Clin Chim Acta. 2001 Oct;312(1-2):41-7. doi: 10.1016/s0009-8981(01)00589-7.
A double-blind, placebo-controlled, parallel-group study was performed to determine whether atorvastatin, a new HMG-CoA reductase inhibitor, could effectively and safely reduce plasma LDL-cholesterol concentrations in Japanese patients with type-2 diabetes without influencing glycemic control. The subjects were patients with hypercholesterolemia (serum cholesterol concentration > or =5.7 mmol/l (220 mg/dl)) and stable glycemic control. The fasting concentrations of hemoglobin A(1C) (HbA(1C)), fructosamine, and 1,5-anhydroglucitol (1,5-AG) were measured as indices of glycemic control. Plasma lipid concentrations and the safety of the drug were also examined. Forty eligible patients in two groups of 20 each were administered atorvastatin (10 mg/day) or placebo. Neither atorvastatin nor placebo caused a significant change in HbA(1C), fructosamine, or 1,5-AG concentrations. Atorvastatin significantly reduced total cholesterol and LDL-cholesterol concentrations from baseline by 29.7% (p<0.0001) and 41.6% (p<0.0001), respectively. The incidence of clinical adverse events and that of abnormal changes in laboratory test values did not differ between the two groups. In this trial, atorvastatin effectively and safely reduced LDL-cholesterol concentrations in diabetic patients with hypercholesterolemia without influencing glycemic control. These findings are clinically important because there are many diabetic patients with hypercholesterolemia and such patients have a high risk of developing arteriosclerotic disease.
进行了一项双盲、安慰剂对照、平行组研究,以确定新型HMG-CoA还原酶抑制剂阿托伐他汀是否能有效且安全地降低2型糖尿病日本患者的血浆低密度脂蛋白胆固醇浓度,同时不影响血糖控制。研究对象为高胆固醇血症患者(血清胆固醇浓度≥5.7 mmol/l(220 mg/dl))且血糖控制稳定。测量空腹血红蛋白A1C(HbA1C)、果糖胺和1,5-脱水葡萄糖醇(1,5-AG)的浓度作为血糖控制指标。还检测了血浆脂质浓度和药物安全性。将40名符合条件的患者分为两组,每组20人,分别给予阿托伐他汀(10 mg/天)或安慰剂。阿托伐他汀和安慰剂均未导致HbA1C、果糖胺或1,5-AG浓度发生显著变化。阿托伐他汀使总胆固醇和低密度脂蛋白胆固醇浓度较基线水平分别显著降低了29.7%(p<0.0001)和41.6%(p<0.0001)。两组临床不良事件的发生率和实验室检查值异常变化的发生率无差异。在本试验中,阿托伐他汀有效且安全地降低了高胆固醇血症糖尿病患者的低密度脂蛋白胆固醇浓度,同时不影响血糖控制。这些发现具有临床重要性,因为有许多高胆固醇血症糖尿病患者,且这类患者发生动脉粥样硬化疾病的风险很高。