Department of Internal Medicine and Clinical Pharmacology, Medical University of Silesia, Katowice, Poland.
Am J Cardiol. 2011 Apr 1;107(7):1010-1018.e1. doi: 10.1016/j.amjcard.2010.11.023. Epub 2011 Jan 26.
The aim of our study was to compare the effect of simvastatin and fenofibrate treatment on the secretory function of human monocytes and lymphocytes and on systemic inflammation in type 2 diabetes and to assess whether their coadministration is superior to treatment with only 1 of these drugs. One hundred ninety-six adult patients with recently diagnosed and previously untreated type 2 diabetes and mixed dyslipidemia, complying throughout the study with lifestyle intervention and treated with metformin, were randomized in a double-blind fashion to receive simvastatin (40 mg), fenofibrate (200 mg), simvastatin plus fenofibrate, or placebo for 90 days. Main outcome measurements were monocyte and lymphocyte release of proinflammatory cytokines and plasma levels of C-reactive protein. One hundred ninety patients completed the study. Simvastatin and fenofibrate decreased monocyte release of tumor necrosis factor-α, interleukin-1β, interleukin-6, and monocyte chemoattractant protein-1 and lymphocyte release of interleukin-2, interferon-γ, and tumor necrosis factor-α, which was accompanied by a decrease in plasma C-reactive protein levels. Anti-inflammatory effects of fenofibrate partly correlated with the improvement in insulin sensitivity. Lymphocyte-suppressing, but not monocyte-suppressing, effect was stronger if these 2 agents were administered together. In conclusion, simvastatin and fenofibrate exhibit a similar effect on the secretory function of human monocytes and lymphocytes and on systemic inflammation in type 2 diabetic subjects with mixed dyslipidemia. This effect may be clinically relevant in the prevention of vascular complications in metformin- and diet-treated subjects with newly diagnosed diabetic dyslipidemia.
我们的研究目的是比较辛伐他汀和非诺贝特治疗对 2 型糖尿病患者人单核细胞和淋巴细胞分泌功能以及全身炎症的影响，并评估这两种药物联合应用是否优于单一药物治疗。196 例新诊断和未经治疗的 2 型糖尿病伴混合性血脂异常的成年患者，在整个研究期间遵循生活方式干预，并接受二甲双胍治疗，以双盲方式随机分为辛伐他汀（40mg）、非诺贝特（200mg）、辛伐他汀加非诺贝特或安慰剂组，治疗 90 天。主要观察指标是单核细胞和淋巴细胞释放促炎细胞因子的情况以及 C 反应蛋白的血浆水平。190 例患者完成了研究。辛伐他汀和非诺贝特降低了单核细胞释放肿瘤坏死因子-α、白细胞介素-1β、白细胞介素-6 和单核细胞趋化蛋白-1，以及淋巴细胞释放白细胞介素-2、干扰素-γ和肿瘤坏死因子-α，同时伴有 C 反应蛋白水平降低。非诺贝特的抗炎作用部分与胰岛素敏感性的改善相关。如果这两种药物联合使用，淋巴细胞的抑制作用（而非单核细胞）更强。总之，辛伐他汀和非诺贝特对 2 型糖尿病伴混合性血脂异常患者的单核细胞和淋巴细胞分泌功能以及全身炎症具有相似的作用。这种作用在预防新诊断糖尿病血脂异常的二甲双胍和饮食治疗患者的血管并发症方面可能具有临床意义。
