Section of Endocrinology and Metabolism, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC.
Division of Endocrinology and Metabolism, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan, ROC.
J Chin Med Assoc. 2022 Aug 1;85(8):831-838. doi: 10.1097/JCMA.0000000000000765. Epub 2022 Jun 20.
This study compared the efficacy of two statin treatments (simvastatin vs rosuvastatin) in achieving the combined goal of low-density lipoprotein cholesterol (LDL-C) <2.6 mmol/L and non-high-density lipoprotein cholesterol (non-HDL-C) <3.4 mmol/L in patients with type 2 diabetes and dyslipidemia.
After a 5-week run-in, 89 patients with type 2 diabetes having fasting triglyceride (TG) levels of 1.7 to 5.7 mmol/L or non-HDL-C levels of 3.4 to 5.2 mmol/L were randomized to receive simvastatin 20 mg daily for 4 weeks followed by 40 mg for 8 weeks or rosuvastatin 10 mg for 4 weeks followed by 20 mg for 8 weeks. The primary end-point was the percentage of patients achieving the combined goal at week 12.
Although significant between-group differences were observed in changes in LDL-C and non-HDL-C levels, both study treatments were sufficiently intensive for a 40% to 55% LDL-C reduction. At the end of the study, the two groups had similar percentages of patients who achieved the combined lipid goal (84% vs 89%, p = 0.66). All patients who attained the combined lipid goal also met the apolipoprotein B (Apo-B) target of <0.9 g/L. No between-group differences were noted in changes in HDL-C and TG levels at week 12. The patients tolerated both treatments well.
In our study, ≈85% of patients with type 2 diabetes and dyslipidemia could achieve the combined lipid goal with statin monotherapy. The two statin treatments could sufficiently control diabetic dyslipidemia (NCT00506961).
本研究比较了两种他汀类药物(辛伐他汀与瑞舒伐他汀)治疗在实现 2 型糖尿病伴血脂异常患者的联合目标(低密度脂蛋白胆固醇(LDL-C)<2.6mmol/L 和非高密度脂蛋白胆固醇(non-HDL-C)<3.4mmol/L)中的疗效。
89 例 2 型糖尿病患者在 5 周的导入期后,空腹甘油三酯(TG)水平为 1.7 至 5.7mmol/L 或非高密度脂蛋白胆固醇(non-HDL-C)水平为 3.4 至 5.2mmol/L,随机分为辛伐他汀组(每天 20mg 治疗 4 周,然后每天 40mg 治疗 8 周)或瑞舒伐他汀组(每天 10mg 治疗 4 周,然后每天 20mg 治疗 8 周)。主要终点是治疗 12 周时达到联合目标的患者比例。
尽管 LDL-C 和 non-HDL-C 水平的组间变化存在显著差异,但两种研究治疗均足以实现 40%至 55%的 LDL-C 降低。研究结束时,两组达到联合血脂目标的患者比例相似(84%比 89%,p=0.66)。达到联合血脂目标的所有患者也达到了载脂蛋白 B(Apo-B)<0.9g/L 的目标。治疗 12 周时,两组的 HDL-C 和 TG 水平变化无差异。患者均能良好耐受两种治疗。
在我们的研究中,约 85%的 2 型糖尿病伴血脂异常患者可通过他汀类药物单药治疗达到联合血脂目标。两种他汀类药物均可充分控制糖尿病血脂异常(NCT00506961)。