מתוך אתר medicontext.co.il
WESTPORT, CT (Reuters Health) – Standard and high-dose atorvastatin therapy provide similar reductions in triglyceride levels in patients with type 2 diabetes mellitus, but high-dose therapy produces a greater improvement in cholesterol-related parameters.
In the Diabetes Atorvastatin Lipid Intervention study, Dr. R. P. Stolk, from the University Medical Center Utrecht, in the Netherlands, and colleagues assessed the lipid-related outcomes of 217 type 2 diabetics who were randomized to receive 10 mg or 80 mg of atorvastatin or placebo once daily for 30 weeks. All of the patients had fasting triglyceride levels at baseline of 1.5 to 6.0 mmol/L.
Both doses produced similar significant reductions in plasma triglyceride levels and increases in HDL-cholesterol levels, the authors note (p < 0.001 and < 0.005, respectively). However, while both doses led to significant reductions in total cholesterol, LDL cholesterol, and apolipoprotein B (apo B) levels, the effect was significantly greater with high-dose therapy, the researchers found (p < 0.005).
"This reduction is of the same magnitude as that found in studies of atorvastatin in nondiabetic hypercholesterolemic and hypertriglyceridemic patients," they report in the August issue of Diabetes Care.
The side-effect profile of atorvastatin at the standard or high dose did not differ significantly from that of placebo, they note.
The total cholesterol:HDL cholesterol ratio "was one of the best predictors of future cardiovascular events in the Framingham study," the investigators point out. "Because treatment with 80 mg of atorvastatin resulted in a significantly lower total cholesterol:HDL cholesterol ratio than 10 mg of atorvastatin, the high dose may have an additional protective effect on future cardiovascular events."
Diabetes Care 2001;24:1335-1341.
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