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阿托伐他汀与瑞舒伐他汀对血脂异常 2 型糖尿病患者炎症生物标志物和左心室功能的影响。

Effect of atorvastatin versus rosuvastatin on inflammatory biomarkers and LV function in type 2 diabetic patients with dyslipidemia.

机构信息

Faculty of Pharmacy, Clinical Pharmacy Department, Damanhur University, El- Bahiara, Egypt.

Faculty of Medicine, Cardiology Department, Tanta University, El-Gharbia, Egypt.

出版信息

Biomed Pharmacother. 2021 Mar;135:111179. doi: 10.1016/j.biopha.2020.111179. Epub 2021 Jan 2.

Abstract

BACKGROUND

Statins are potential drugs for decreasing risk of atherosclerotic cardiovascular complications in type 2 diabetic (T2D) patients.

PURPOSE

To examine the efficacy of both rosuvastatin (ROSUVA) and atorvastatin (ATORVA) on LV function and markers of inflammation in T2D patients with dyslipidemia.

METHODS

One hundred-sixty T2D patients were assigned to receive either atorvastatin (ATORVA group, n = 80, 40 mg) or rosuvastatin (ROSUVA group, n = 80, 10 mg), daily for 6 months. Blood was collected for biochemical analysis. The prevalence of left ventricular abnormalities was determined by echocardiography and two-dimensional Speckle-Strain to assess Global Longitudinal Strain (GLS).

RESULTS

ROSUVA vs. ATORVA resulted in significant (p < 0.001) reduction in HbA1c % (9.13 vs 2.35%), LDL-C (22.23% vs. 14.75%), triglycerides (13.56 % vs. 8.21 %), total cholesterol (16.10 % vs. 10.81 %), atherogenic index (18.08. % vs. 10.97%), hs-CRP (23.51 % vs.18.96%), sortilin (33.33 % % vs. 15.08 %), and leptin (31.81 % vs. 23.17 %) but increased adiponectin (97.99 % vs.76.47.1 %) and HDL-C (76.47 % vs. 0.21 %) compared with baseline, respectively. Negative correlations between adiponectin and each of hs-CRP, HbA1c%, total cholesterol, LDL-C, atherogenic index and leptin were found. Also, left ventricular functions were correlated with adiponectin, lipids, HbA1c% and hs-CRP. The areas under receiver operating characteristic curve (AUC) showed that hs-CRP, leptin, sortlin, leptin, and adiponectin were good predictors for cardiovascular events.

CONCLUSION

ROSUVA is more efficacious in improving lipid profile, atherogenic index and modulation of inflammatory biomarkers in dyslipidemic T2D patients compared with ATROVA. However, both statins are equivalent as cardioprotective agents in dyslipidemic T2D patients.

摘要

背景

他汀类药物有可能降低 2 型糖尿病(T2D)患者发生动脉粥样硬化心血管并发症的风险。

目的

研究瑞舒伐他汀(ROSUVA)和阿托伐他汀(ATORVA)对血脂异常的 T2D 患者左心室功能和炎症标志物的疗效。

方法

160 名 T2D 患者被分为阿托伐他汀组(ATORVA 组,n=80,40mg)或瑞舒伐他汀组(ROSUVA 组,n=80,10mg),每天服用 6 个月。采集血液进行生化分析。通过超声心动图和二维斑点应变评估整体纵向应变(GLS)来确定左心室异常的发生率。

结果

与 ATORVA 相比,ROSUVA 可显著(p<0.001)降低 HbA1c%(9.13%比 2.35%)、LDL-C(22.23%比 14.75%)、甘油三酯(13.56%比 8.21%)、总胆固醇(16.10%比 10.81%)、致动脉粥样硬化指数(18.08%比 10.97%)、hs-CRP(23.51%比 18.96%)、sortilin(33.33%比 15.08%)和瘦素(31.81%比 23.17%),但增加了脂联素(97.99%比 76.47%)和 HDL-C(76.47%比 0.21%)。与基线相比,hs-CRP、HbA1c%、总胆固醇、LDL-C、致动脉粥样硬化指数和瘦素之间存在负相关关系。左心室功能与脂联素、血脂、HbA1c%和 hs-CRP 相关。受试者工作特征曲线(ROC)下面积(AUC)显示 hs-CRP、瘦素、sortilin、瘦素和脂联素是心血管事件的良好预测因子。

结论

与 ATORVA 相比,ROSUVA 更有效改善血脂异常、T2D 患者的致动脉粥样硬化指数和炎症生物标志物。然而,两种他汀类药物在血脂异常的 T2D 患者中作为心脏保护剂是等效的。

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