Department of Internal Medicine, University "Tor Vergata", Rome, Italy.
Atherosclerosis. 2012 Jul;223(1):197-203. doi: 10.1016/j.atherosclerosis.2012.04.015. Epub 2012 May 8.
We evaluated the long-term effects of rosuvastatin and simvastatin on insulin sensitivity and secretion in patients with well-controlled type 2 diabetes.
After a 3 weeks run-in, 27 eligible patients were randomly assigned to receive either rosuvastatin 20 mg daily (Group 1) or simvastatin 20 mg daily (Group 2) for 6 months; thereafter they were switched to the other treatment for additional 6 months. Patients were recruited among individuals attending the outpatient service of the Diabetology Unit of the "Policlinico Tor Vergata" University Hospital, Rome, Italy. Serum lipids, glucose and insulin, glycated hemoglobin, C-reactive protein, TNF-α, leptin, adiponectin, insulin sensitivity by euglycemic-hyperinsulinemic clamp, β-cells function by HOMA-β were assessed at months 0, 6 and 12. Additionally, endothelial function was assessed by use of the brachial artery reactivity technique.
Besides marked reduction in lipid levels, glycated hemoglobin significantly increased from baseline after 12 months in both Group 1 (+0.8 ± 0.2%, p < 0.001) and Group 2 (+0.9 ± 0.3%; p < 0.001). Similar trends were observed for fasting glucose in both groups. No changes in insulin sensitivity were detected throughout the study, whereas HOMA-β significantly decreased from baseline after 12 months in both Group 1 (-21.9%, p < 0.01) and Group 2 (-38.9%; p < 0.001). In addition, both treatments similarly decreased C-reactive protein and leptin, as well as improved endothelial function. No changes in anthropometric measures were observed.
In well-controlled type 2 diabetic patients both rosuvastatin and simvastatin significantly impaired glycemic control and insulin secretion, without affecting insulin sensitivity.
评估瑞舒伐他汀和辛伐他汀对血糖控制良好的 2 型糖尿病患者胰岛素敏感性和分泌的长期影响。
经过 3 周的导入期后，27 名符合条件的患者被随机分为两组，分别接受瑞舒伐他汀 20mg 每日（第 1 组）或辛伐他汀 20mg 每日（第 2 组）治疗 6 个月；之后，他们切换到另一种治疗方案再治疗 6 个月。患者是从意大利罗马“Tor Vergata”大学医院糖尿病门诊的个体中招募的。在 0 个月、6 个月和 12 个月时，评估血清脂质、葡萄糖和胰岛素、糖化血红蛋白、C 反应蛋白、TNF-α、瘦素、脂联素、通过正葡萄糖高胰岛素钳夹评估胰岛素敏感性、通过 HOMA-β 评估β细胞功能。此外，还通过肱动脉反应性技术评估内皮功能。
除了血脂水平显著降低外，两组患者的糖化血红蛋白在 12 个月时均较基线显著升高（第 1 组增加 0.8±0.2%，p<0.001；第 2 组增加 0.9±0.3%，p<0.001）。两组患者的空腹血糖也呈现类似的趋势。在整个研究过程中，胰岛素敏感性没有变化，而两组患者的 HOMA-β在 12 个月时均较基线显著降低（第 1 组降低 21.9%，p<0.01；第 2 组降低 38.9%，p<0.001）。此外，两种治疗方法均能降低 C 反应蛋白和瘦素，改善内皮功能。体重指数等人体测量指标没有变化。
在血糖控制良好的 2 型糖尿病患者中，瑞舒伐他汀和辛伐他汀均显著影响血糖控制和胰岛素分泌，而不影响胰岛素敏感性。
