[Rosuvastatin and fenofibrate in patients with diabetes and low high density lipoprotein cholesterol: comparison of changes of lipid levels and some markers of inflammation].

PURPOSE

To compare lipid lowering profile and effects on markers of inflammation of rosuvastatin and fenofibrate in patients with type 2 diabetes with low high density lipoprotein (HDL) cholesterol (CH).

METHODS

We enrolled into randomized open comparative study 30 pts (20 women) aged 62.5 +/- 7.2 (47-74) years with type 2 diabetes and low HDLCH level (below 1.0 mmol/l for men and 1.2 mmol/l for women). All patients had arterial hypertension, 25--coronary heart disease, 4--peripheral arterial disease. Baseline BMI was > 25 kg/m2 in all patients (above 30 kg/m2 in 70%). Median waist circumference was 105.5 cm. Patients were assigned to receive either rosuvastatin 10 mg/day (n=17) or fenobibrate 200 mg/day (n=13). Serum lipids, high sensitivity C reactive protein (CPR), interleukin 6 (IL-6) and fibrinogen levels were measured at baseline and after 3 months.

RESULTS

Median fasting glucose and HbA1c were 9.14 mmol/l and 6.8%, 8.78 mmol/l and 7.0% at baseline and study end respectively, without significant differences between groups. Mean baseline levels of low density lipoprotein (LDL) CH, HDLCH and triglycerides (TG) were 3.9, 0.93, and 2.39 mmol/l, respectively. Median baseline CRP was relatively low (1.5, interquartile range 0.78-3.08 mg/l). Both rosuvastatin and fenofibrate decreased total CH, LDLCH and TG and increased HDLCH. Tendencies to more pronounced effect of rosuvastatin on total and LDL CH and fenofibrate on TG and HDLCH were not statistically significant. CPR, IL-6, and fibrinogen levels did not significantly change in either group. There were no associations between changes of lipid levels and those of CRP or IL-6 when all patients were taken together.

CONCLUSION

In this relatively small group of overweight diabetics with low HDLCH rosuvastatin and fenofibrate exerted expected effects on lipid profile. However 3 months administration of both starting dose of rosuvastatin (10 mg) and standard dose of fenofibrate was similarly neutral relative to CPR, IL-6 and fibrinogen levels. This can reflect true absence of marked effect or be a consequence of low baseline values of these markers of inflammation.