Ukinc Kubilay, Ersoz Halil Onder, Erem Cihangir, Hacihasanoglu Arif Bayram, Karti Suleyman Sami
Department of Endocrinology and Metabolism, Karadeniz Technical University, Trabzon, Turkey.
Endocrine. 2009 Jun;35(3):380-8. doi: 10.1007/s12020-009-9157-3. Epub 2009 Mar 4.
Type 2 diabetes mellitus is the leading cause of macrovascular diseases and related death. Additionally, diabetes mellitus is frequently complicated by other cardiovascular risk factors, such as hypercholesterolemia, hypertension, obesity, hypercoagulability, and inflammation. We wanted to evaluate and compare the effects of treating with a one-year course of atorvastatin or simvastatin on inflammatory markers such as high sensitive C-reactive protein (hsCRP), fibrinogen, and ferritin in uncontrolled type 2 diabetic patients. Also, we planned to investigate the correlation between inflammatory markers and metabolic parameters. Fifty type 2 diabetic patients (30 women, 20 men; mean age: 49.9 +/- 8.5 years) were enrolled into the study. Twenty healthy subjects, matched on body mass index and age, were also included in the study as a control group. Diabetic patients were divided into two groups and received simvastatin or atorvastatin (Group S and A, respectively). After 1 year of statin treatment (Group A), there were significant decreases in total cholesterol (217.3 +/- 46.5-173.8 +/- 37.2 mg/dl; P < 0.0001), LDL-cholesterol (146.7 +/- 50.3-102.3 +/- 31.1 mg/dl, P < 0.0001), hsCRP (0.88 +/- 0.62-0.35 +/- 0.18 mg/dl, P < 0.0001), fibrinogen (258.2 +/- 16.9-215.5 +/- 10.6 mg/l; P < 0.0001), and ferritin (118.2 +/- 73.9-81.2 +/- 72.5 ng/ml, P < 0.0001) levels compared to basal values. In the S group, there were significant decreases in total cholesterol (224.4 +/- 61.2-175.0 +/- 47.8 mg/dl; P < 0.0001), LDL-cholesterol (140.9 +/- 56.7-110.9 +/- 42.2 mg/dl, P < 0.0001), hsCRP (0.98 +/- 1.3-0.46 +/- 0.25 mg/dl, P < 0.0001), fibrinogen (265.7 +/- 26.8-222.1 +/- 20.6 mg/l; P < 0.0001), and ferritin (136.7 +/- 101.1-85.6 +/- 32.1 ng/ml, P < 0.0001) levels compared to basal values. At the end of the study, hsCRP, fibrinogen, and ferritin levels were correlated with LDL (r = 0.42; P = 0.005, with hsCRP), (r = 0.40; P = 0.008, with fibrinogen), (r = 0.46; P = 0.002, with ferritin) and HDL (r = -0.50; P < 0.0001, with hsCRP), (r = -0.32; p = 0.042, with fibrinogen), (r = -0.48; P < 0.0001, with ferritin) cholesterol levels. Atorvastatin and simvastatin treatments were found to be effective for the control of hypercholesterolemia and resulted in a significant decrease in acute phase reactants in uncontrolled type 2 diabetic patients.
2型糖尿病是大血管疾病及相关死亡的主要原因。此外,糖尿病常并发其他心血管危险因素,如高胆固醇血症、高血压、肥胖、高凝状态和炎症。我们希望评估并比较阿托伐他汀或辛伐他汀治疗1年对未控制的2型糖尿病患者炎症标志物(如高敏C反应蛋白(hsCRP)、纤维蛋白原和铁蛋白)的影响。此外,我们计划研究炎症标志物与代谢参数之间的相关性。50例2型糖尿病患者(30例女性,20例男性;平均年龄:49.9±8.5岁)被纳入研究。另外,20名在体重指数和年龄上匹配的健康受试者作为对照组也被纳入研究。糖尿病患者被分为两组,分别接受辛伐他汀或阿托伐他汀治疗(分别为S组和A组)。他汀类药物治疗1年后(A组),与基础值相比,总胆固醇(217.3±46.5 - 173.8±37.2mg/dl;P<0.0001)、低密度脂蛋白胆固醇(146.7±50.3 - 102.3±31.1mg/dl,P<0.0001)、hsCRP(0.88±0.62 - 0.35±0.18mg/dl,P<0.0001)、纤维蛋白原(258.2±16.9 - 215.5±10.6mg/l;P<0.0001)和铁蛋白(118.2±73.9 - 81.2±72.5ng/ml,P<0.0001)水平均显著降低。在S组,与基础值相比,总胆固醇(224.4±61.2 - 175.0±47.8mg/dl;P<0.0001)、低密度脂蛋白胆固醇(140.9±56.7 - 110.9±42.2mg/dl,P<0.0001)、hsCRP(0.98±1.3 - 0.46±0.25mg/dl,P<0.0001)、纤维蛋白原(265.7±26.8 - 222.1±20.6mg/l;P<0.0001)和铁蛋白(136.7±101.1 - 85.6±32.1ng/ml,P<0.0001)水平均显著降低。在研究结束时,hsCRP、纤维蛋白原和铁蛋白水平与低密度脂蛋白(与hsCRP相关:r = 0.42;P = 0.005)、(与纤维蛋白原相关:r = 0.40;P = 0.0