First Department of Internal Medicine, Hippokratio General Hospital of Thessaloniki, Thessaloniki, Greece.
Acta Diabetol. 2012 Aug;49(4):269-76. doi: 10.1007/s00592-011-0310-0. Epub 2011 Jul 12.
To investigate the influence of atrovastatin treatment on carotid intima-media thickness (CIMT) and serum levels of novel adipokines, like apelin, visfatin (nampt), and ghrelin, in patients with type 2 diabetes mellitus (T2DM). 87 statin-free patients (50 males) with T2DM, aged 55-70, but without carotid atherosclerotic plaques were initially enrolled. CIMT was assayed in all participants by ultrasound. Patients were then treated with atorvastatin (10-80 mg) to target LDL <100 mg/dl. Anthropometric parameters, blood pressure, glycemic and lipid profile, high-sensitivity CRP (hsCRP), insulin resistance (HOMA-IR), apelin, visfatin and ghrelin were measured at baseline and after 12 months. Atorvastatin treatment significantly improved lipid profile across with increased apelin (from 0.307 ± 0.130 pg/ml to 1.537 ± 0.427 pg/ml; P < 0.001) and suppressed visfatin (from 21.54 ± 10.14 ng/ml to 15.13 ± 7.61 ng/ml; P = 0.002) serum levels in our diabetic patients. Standard multiple regression analysis showed that the atorvastatin-induced increment in apelin was independently associated with changes in total cholesterol (β = -0.510, P = 0.030) and LDL-cholesterol (β = -0.590, P < 0.001) (R (2) = 0.449, P = 0.014), while the reduction of visfatin concentration was independently associated with the change in hsCRP (β = 0.589, P < 0.001; R (2) = 0.256, P = 0.006), after adjustment for age, sex and BMI. CIMT and ghrelin did not alter significantly after 12 months of atorvastatin treatment (NS). Among participants, high-dose (80 mg) rather than low-dose (10 mg) of atorvastatin treatment yielded greater (P < 0.05) changes in apelin, visfatin and CIMT levels despite the final equivalent levels of LDL. Atorvastatin administration increased apelin and decreased visfatin serum levels significantly, without change of CIMT, in patients with T2DM. However, high-dose of atorvastatin exerted more favourable impact on adipokines and CIMT than low-dose. Our results implicate another important link between adiposity and atherosclerosis.
探讨阿托伐他汀治疗对 2 型糖尿病（T2DM）患者颈动脉内膜中层厚度（CIMT）和新型脂肪因子（如 Apelin、Visfatin[Nampt]和 Ghrelin）血清水平的影响。
我们最初纳入了 87 名未服用他汀类药物的 T2DM 患者（50 名男性），年龄 55-70 岁，但无颈动脉粥样硬化斑块。所有参与者均通过超声检测 CIMT。然后，患者接受阿托伐他汀（10-80mg）治疗，以将 LDL 控制在<100mg/dl。在基线和 12 个月时测量人体测量参数、血压、血糖和血脂谱、高敏 C 反应蛋白（hsCRP）、胰岛素抵抗（HOMA-IR）、Apelin、Visfatin 和 Ghrelin。
阿托伐他汀治疗可显著改善血脂谱，同时增加 Apelin（从 0.307±0.130pg/ml 增加至 1.537±0.427pg/ml；P<0.001）和抑制 Visfatin（从 21.54±10.14ng/ml 降低至 15.13±7.61ng/ml；P=0.002）血清水平。多元逐步回归分析显示，阿托伐他汀诱导的 Apelin 增加与总胆固醇（β=-0.510，P=0.030）和 LDL 胆固醇（β=-0.590，P<0.001）的变化独立相关（R2=0.449，P=0.014），而 Visfatin 浓度的降低与 hsCRP 的变化独立相关（β=0.589，P<0.001；R2=0.256，P=0.006），调整年龄、性别和 BMI 后。阿托伐他汀治疗 12 个月后 CIMT 和 Ghrelin 无显著变化（NS）。尽管最终 LDL 水平相当，但与低剂量（10mg）相比，高剂量（80mg）阿托伐他汀治疗可使 Apelin、Visfatin 和 CIMT 水平的变化更显著（P<0.05）。阿托伐他汀治疗可显著增加 T2DM 患者的 Apelin 水平，降低 Visfatin 血清水平，而 CIMT 无变化。然而，高剂量阿托伐他汀对脂联素和 CIMT 的影响比低剂量更为有利。我们的结果提示肥胖与动脉粥样硬化之间存在另一个重要联系。
