van Deursen R T, Nieuwenhuijzen Kruseman A C, Degenaar C P, Wolffenbuttel B H
Afd. Inwendige Geneeskunde, Academisch Ziekenhuis, Maastricht.
Ned Tijdschr Geneeskd. 1990 Nov 3;134(44):2142-6.
We studied the short-term effects of simvastatin on lipid variables in 33 dyslipidemic patients without and 18 with diabetes mellitus who were on a lipid-lowering diet for at least 3 months. Six diabetic patients had type I, and 12 had type II diabetes mellitus, of whom 5 were using insulin. In the whole group total cholesterol decreased by 28%, from 9.35 (SD 2.10) mmol/l to 6.69 (SD 1.47) mmol/l after 3 months and 6.60 (SD 1.27) mmol/l after 6 months (mean daily dose of simvastatin 21 (SD 12) mg). Calculated LDL-cholesterol showed a decrease of 38%, HDL-cholesterol increased by 10% and plasma triglycerides decreased by 13%. In patients receiving 10, 20, or 40 mg simvastatin daily, the following changes were observed: total cholesterol -26, -31 and -34% and LDL-cholesterol -37, -38 and -39%, respectively. The effect of simvastatin in the diabetic patients was comparable with that in the non-diabetic individuals, although in the diabetics LDL-cholesterol before therapy was lower, as was the daily dose of simvastatin after 6 months (14 versus 24 mg). In the diabetic patients blood glucose control, measured as HbA1c, was not affected. One patient discontinued therapy because of stomach complaints. Our results show that a low daily dose (10 mg) of simvastatin effectively lowers plasma total and LDL-cholesterol and that the drug can be safely used in diabetic patients.
我们研究了辛伐他汀对33名非糖尿病血脂异常患者和18名糖尿病血脂异常患者血脂指标的短期影响，这些患者接受降脂饮食至少3个月。6名糖尿病患者为I型糖尿病，12名患者为II型糖尿病，其中5名患者正在使用胰岛素。在整个研究组中，总胆固醇在3个月后从9.35（标准差2.10）mmol/l降至6.69（标准差1.47）mmol/l，下降了28%，6个月后降至6.60（标准差1.27）mmol/l（辛伐他汀平均日剂量为21（标准差12）mg）。计算得出的低密度脂蛋白胆固醇下降了38%，高密度脂蛋白胆固醇升高了10%，血浆甘油三酯下降了13%。在每日服用10、20或40 mg辛伐他汀的患者中，观察到以下变化：总胆固醇分别下降26%、31%和34%，低密度脂蛋白胆固醇分别下降37%、38%和39%。辛伐他汀在糖尿病患者中的效果与非糖尿病患者相当，尽管糖尿病患者治疗前的低密度脂蛋白胆固醇较低，6个月后的辛伐他汀日剂量也较低（分别为14 mg和24 mg）。在糖尿病患者中，以糖化血红蛋白（HbA1c）衡量的血糖控制未受影响。一名患者因胃部不适而停止治疗。我们的研究结果表明，低剂量（10 mg）的辛伐他汀能有效降低血浆总胆固醇和低密度脂蛋白胆固醇，且该药物可安全用于糖尿病患者。
