Hao Z, Liu Y, Liao H, Zheng D, Xiao C, Li G
The Third People's Hospital of Huizhou, Huizhou, Guangdong Province, China.
The Eastern Hospital of the First Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong Province, China.
Exp Clin Endocrinol Diabetes. 2016 Apr;124(4):246-50. doi: 10.1055/s-0035-1569364. Epub 2016 Apr 28.
Atorvastatin and metformin both have pleiotropic effects. Whether atorvastatin combined with metformin could provide additive benefits on subjects with dyslipidemia and overweight/obese is unknown. And the mechanism is also not fully clear yet.
A cross-sectional research was performed and 130 subjects with dyslipidemia and overweight/obese were enrolled and randomly assigned into combined group (20 mg of atorvastatin daily plus 500 mg of metformin twice daily) and control group (20 mg of atorvastatin daily). At baseline and 8 weeks later, parameters of interest were recorded and fasting venous blood was drawn for laboratory examination.
The rates of overweight (76.9% vs. 73.8%) and obese (23.1% vs. 26.2%) in both group were comparable. Dyslipidemia in both groups were featured by increased serum levels of triglyceride (TG), total cholesterol (TC) and low-density lipoprotein cholesterol (LDL-C). Serum level of high sensitivity C-reactive protein (Hs-CRP) was comparably elevated in both groups at baseline, and leukocyte rho-associated kinase 2 (ROCK2) and serum nitric oxide (NO) concentrations were also comparable. Generally, the baseline characteristics between these 2 groups were no significant differences. 8 weeks later, compared to baseline, body mass index (BMI), the rates of overweight and obese, daily exercise time, smoking status, lipid profiles, Hs-CRP level, leukocyte ROCK2 and serum NO concentrations in both groups were improved. Notably, compared to control group, the rate of obese, Hs-CRP level, leukocyte ROCK2 and serum NO concentrations were improved more profoundly in the combined group (p<0.05). After adjusted for age, gender, BMI, TG, LDL-C, Hs-CRP and exercise time, atorvastatin plus metformin was positively associated with serum NO concentration, with odds ratio (OR) of 1.146 (95% confidence interval (CI) 1.089-1.164, combined group vs. control group, p<0.05), and inversely associated with leukocyte ROCK2 concentration, with OR of 0.853 (95% CI 0.834-0.872, combined group vs. control group, p<0.05).
In subjects with dyslipidemia and overweight/obese, atorvastatin plus metformin may confer additive benefits through reducing leukocyte ROCK2 concentration.
阿托伐他汀和二甲双胍都具有多效性。阿托伐他汀与二甲双胍联合使用是否能为血脂异常和超重/肥胖患者带来额外益处尚不清楚。其机制也尚未完全明确。
进行了一项横断面研究，纳入130例血脂异常和超重/肥胖患者，并随机分为联合治疗组（每日服用20mg阿托伐他汀加每日两次服用500mg二甲双胍）和对照组（每日服用20mg阿托伐他汀）。在基线和8周后，记录相关参数，并采集空腹静脉血进行实验室检查。
两组的超重率（76.9%对73.8%）和肥胖率（23.1%对26.2%）相当。两组血脂异常均表现为血清甘油三酯（TG）、总胆固醇（TC）和低密度脂蛋白胆固醇（LDL-C）水平升高。两组在基线时高敏C反应蛋白（Hs-CRP）血清水平均有相当程度升高，白细胞Rho相关激酶2（ROCK2）和血清一氧化氮（NO）浓度也相当。总体而言，这两组之间的基线特征无显著差异。8周后，与基线相比，两组的体重指数（BMI）、超重和肥胖率、每日运动时间、吸烟状况、血脂谱、Hs-CRP水平、白细胞ROCK2和血清NO浓度均有所改善。值得注意的是，与对照组相比，联合治疗组的肥胖率、Hs-CRP水平、白细胞ROCK2和血清NO浓度改善更为显著（p<0.05）。在调整年龄、性别、BMI、TG、LDL-C、Hs-CRP和运动时间后，阿托伐他汀加二甲双胍与血清NO浓度呈正相关，比值比（OR）为1.146（95%置信区间（CI）1.089 - 1.164，联合治疗组对对照组，p<0.05），与白细胞ROCK2浓度呈负相关，OR为0.853（95%CI 0.834 - 0.872，联合治疗组对对照组，p<0.05）。
在血脂异常和超重/肥胖患者中，阿托伐他汀加二甲双胍可能通过降低白细胞ROCK2浓度带来额外益处。
