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瑞舒伐他汀与辛伐他汀对 2 型糖尿病患者早期血管和代谢的影响比较。

Early vascular and metabolic effects of rosuvastatin compared with simvastatin in patients with type 2 diabetes.

机构信息

Department of Internal Medicine, University of Rome Tor Vergata, Via Montpellier,1, I-00133 Rome, Italy.

出版信息

Atherosclerosis. 2010 May;210(1):199-201. doi: 10.1016/j.atherosclerosis.2009.11.021. Epub 2009 Nov 20.

Abstract

OBJECTIVE

To compare the short-term effects of rosuvastatin and simvastatin on insulin-resistance and endothelial dysfunction in middle-aged patients with type 2 diabetes and mild untreated dyslipidemia.

METHODS AND DESIGN

29 Subjects randomly assigned to rosuvastatin 20mg/daily or simvastatin 20mg/daily for 4 weeks. Following data collected both pre- and post-treatment: fasting glucose, lipids, hs CRP, TNF-alpha, insulin sensitivity measured with euglycemic-hyperinsulinemic clamp and flow-mediated dilation with brachial artery reactivity technique.

RESULTS

Both treatments markedly reduced LDL cholesterol (p<0.001 for both). Insulin sensitivity did not change from relative baseline values in both groups, as well as fasting glucose and adiponectin. Simvastatin significantly improved flow-mediated dilation (p<0.01), to a greater extent than in patients taking rosuvastatin (p=0.09). We found no association between flow-mediated dilation improvement, LDL reduction and changes in hs CRP levels.

CONCLUSION

In type 2 diabetic individuals rosuvastatin was less effective than simvastatin at improving endothelium-dependent vasodilation within one month, without affecting insulin-resistance, adiponectin levels and inflammation.

摘要

目的

比较瑞舒伐他汀和辛伐他汀对 2 型糖尿病伴轻度未治疗血脂异常的中年患者胰岛素抵抗和内皮功能障碍的短期影响。

方法和设计

29 名受试者随机分配至瑞舒伐他汀 20mg/天或辛伐他汀 20mg/天治疗 4 周。在治疗前后收集以下数据:空腹血糖、血脂、hsCRP、TNF-α、应用正葡萄糖高胰岛素钳夹技术测量的胰岛素敏感性和肱动脉反应性技术测量的血流介导的舒张功能。

结果

两种治疗均显著降低 LDL 胆固醇(均<0.001)。与基线相比,两组的胰岛素敏感性均无变化,空腹血糖和脂联素也无变化。与服用瑞舒伐他汀的患者相比,辛伐他汀显著改善了血流介导的舒张功能(p<0.01)(p=0.09)。我们没有发现血流介导的舒张功能改善、LDL 降低与 hsCRP 水平变化之间的关联。

结论

在 2 型糖尿病患者中,瑞舒伐他汀在一个月内改善内皮依赖性血管舒张的效果不如辛伐他汀,同时对胰岛素抵抗、脂联素水平和炎症没有影响。

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