Boncelj Svetek Maja, Eržen Barbara, Kanc Karin, Šabovič Mišo
Department of Vascular Diseases, University Clinical Center Ljubljana, Zaloška cesta 7, 1000 Ljubljana, Slovenia.
Diabetes & Me, Private Clinic for Diabetes, Židovska 1, 1000 Ljubljana, Slovenia.
J Diabetes Complications. 2017 Mar;31(3):544-550. doi: 10.1016/j.jdiacomp.2016.12.002. Epub 2016 Dec 16.
Patients with type 2 diabetes are at increased cardiovascular risk. The aim was to explore whether the impaired arterial wall characteristics typical of these patients could be improved by the unique beneficial effects of a very low-dose combination of fluvastatin and valsartan (low-flu/val).
Forty middle-aged males (50.4±6.1years) with type 2 diabetes were recruited to a double-blind, randomized study. Patients (N=20) received low-flu/val (10/20mg) or placebo (N=20) over 30days in addition to their regular therapy. Brachial artery flow mediated dilation (FMD), common carotid artery pulse wave velocity (PWV) and β-stiffness were assessed before and after treatment, and 3 and 6months after treatment discontinuation. The treatment was then repeated.
Arterial wall characteristics significantly improved. After 30days of intervention, FMD increased from 2.4±0.3 to 4.2±0.3 (p<0.001), PWV decreased from 6.4±0.1 to 5.8±0.2 (p<0.001) and β stiffness decreased from 7.8±0.4 to 6.7±0.4 (p<0.001). Lipids and arterial pressure did not change. After treatment discontinuation, the beneficial effects decreased over the following months. The repetition of treatment completely regained the initial benefits. No changes were observed in the placebo group.
Low-flu/val added on-top of optimal therapy substantially improves arterial wall characteristics in patients with type 2 diabetes.
2型糖尿病患者心血管风险增加。本研究旨在探讨氟伐他汀与缬沙坦极低剂量联合用药（低氟/缬）的独特有益作用是否能改善这些患者典型的动脉壁特征受损情况。
招募40名中年男性2型糖尿病患者（50.4±6.1岁）进行双盲随机研究。患者（N = 20）在常规治疗基础上，接受30天的低氟/缬（10/20mg）或安慰剂（N = 20）治疗。在治疗前后、停药后3个月和6个月评估肱动脉血流介导的扩张（FMD）、颈总动脉脉搏波速度（PWV）和β硬度。然后重复治疗。
动脉壁特征显著改善。干预30天后，FMD从2.4±0.3增加到4.2±0.3（p<0.001），PWV从6.4±0.1降低到5.8±0.2（p<0.001），β硬度从7.8±0.4降低到6.7±0.4（p<0.001）。血脂和动脉压未改变。停药后，有益效果在接下来的几个月中逐渐降低。重复治疗完全恢复了最初的益处。安慰剂组未观察到变化。
在最佳治疗基础上加用低氟/缬可显著改善2型糖尿病患者的动脉壁特征。
