Akalin Aysen, Temiz Gokhan, Akcar Nevbahar, Sensoy Banu
Department of Endocrinology, Eskisehir Osmangazi University Medical Faculty, Eskisehir, Turkey.
Endocr J. 2008 Oct;55(5):861-6. doi: 10.1507/endocrj.k07e-121. Epub 2008 May 28.
This study was designed in order to investigate the short term effects of atorvastatin on endothelial function and oxidized LDL (oxLDL) levels and to evaluate the association of endothelial dysfunction to oxLDL levels and inflammatory markers in type 2 diabetic patients.
Thirty type 2 diabetic and 11 healthy subjects with LDL levels between 100-160 mg/dl. without a history of cardiovascular event were included in the study. Both groups were matched with respect to age, gender, body mass indices and lipid levels. Flow- mediated dilatation (endothelium dependent, FMD) and nitroglycerine-induced dilatation (endothelium independent, NID) were measured in the brachial artery using high-resolution ultrasound in all participants and carotid artery intima media thickness (IMT) were also evaluated. OxLDL levels, lipid parameters, blood glucose, C-peptide, HbA1c and inflammatory markers including C-reactive protein (CRP), fibrinogen, erythrocyte sedimentation rate (ESR) were studied. Type 2 diabetic patients received 10 mg. Atorvastatin for 6 weeks and FMD and NID were reevaluated and oxLDL levels and inflammatory markers remeasured.
Basal FMD, NID, IMT and oxLDL levels besides inflammatory markers were not significantly different between patients and controls. No correlation was found between inflammatory markers and FMD and NID. Only IMT correlated with fibrinogen levels obtained before treatment. In non-diabetics, IMT also correlated with oxLDL levels (p: 0.013). FMD and NID significantly improved after atorvastatin therapy ((7.62 +/- 7.6 vs. 12.65 +/- 7.8, p<0.001 and 18.22 +/- 9.57 vs. 21.43 +/- 9.6, p: 0.007, respectively). Atorvastatin significantly reduced oxLDL levels (57.85 +/- 10.33 vs. 44.36 +/- 6.34, p<0.001).
Atorvastatin improves endothelial functions and reduces oxLDL levels in type 2 diabetics with average lipid levels in the short term and may have beneficial effects in the prevention of early atherosclerotic changes.
本研究旨在探讨阿托伐他汀对2型糖尿病患者内皮功能和氧化型低密度脂蛋白（oxLDL）水平的短期影响，并评估内皮功能障碍与oxLDL水平及炎症标志物之间的关联。
本研究纳入了30例2型糖尿病患者和11例健康受试者，其低密度脂蛋白（LDL）水平在100 - 160mg/dl之间，且无心血管事件病史。两组在年龄、性别、体重指数和血脂水平方面进行了匹配。所有参与者均使用高分辨率超声测量肱动脉的血流介导的血管舒张（内皮依赖性，FMD）和硝酸甘油诱导的血管舒张（内皮非依赖性，NID），并评估颈动脉内膜中层厚度（IMT）。研究了oxLDL水平、血脂参数、血糖、C肽、糖化血红蛋白（HbA1c）以及包括C反应蛋白（CRP）、纤维蛋白原、红细胞沉降率（ESR）在内的炎症标志物。2型糖尿病患者接受10mg阿托伐他汀治疗6周，然后重新评估FMD和NID，并重新测量oxLDL水平和炎症标志物。
患者和对照组之间，除炎症标志物外，基础FMD、NID、IMT和oxLDL水平无显著差异。未发现炎症标志物与FMD和NID之间存在相关性。仅IMT与治疗前测得的纤维蛋白原水平相关。在非糖尿病患者中，IMT也与oxLDL水平相关（p：0.013）。阿托伐他汀治疗后FMD和NID显著改善（分别为（7.62±7.6对12.65±7.8，p<0.001）和（18.22±9.57对21.43±9.6，p：0.007））。阿托伐他汀显著降低了oxLDL水平（57.85±10.33对44.36±6.34，p<0.001）。
阿托伐他汀可在短期内改善血脂水平正常的2型糖尿病患者的内皮功能并降低oxLDL水平，可能对预防早期动脉粥样硬化改变具有有益作用。
