Preview

Rational Pharmacotherapy in Cardiology

Advanced search

EFFECTS OF ATORVASTATIN ON ENDOTHELIAL DYSFUNCTION IN TYPE 2 DIABETIC PATIENTS WITH DIFFERENT DURATION F THE DISEASE

https://doi.org/10.20996/1819-6446-2013-9-4-354-361

Full Text:

Abstract

Aim. To evaluate dynamics of endothelial vasoregulatory function in type 2 diabetic patients after 6 months of combined treatment with atorvastastin 20 mg/day depending on the disease duration and target lipid levels achievement.
Material and methods. The total of 161 type 2 diabetic patients with dyslipidemia were enrolled into non-randomized open-label study, of which 149 patients were assigned to a group of follow-up (group 1) and 12 to a group of comparison (group 2). All the patients received combined antihypertensive and glucose-lowering therapy. Patients of group 1 were additionally receiving atorvastatin 20 mg/day. Parameters of glucose and lipid metabolism and reactive hyperemia test were assessed in all patients initially and 6 months later.
Results. Patients with newly diagnosed diabetes were more likely to restore endothelial vasoregulatory function as compared to the patients with 1-5 and 6-10 years of diabetes duration (56% vs 42% and 35%, respectively). Patients who reached target lipid levels as compared with those who didn’t, more often revealed normalization of endothelial function (38% vs 33%, respectively). Atorvastatin benefited was more effective in newly diagnosed diabetic patients who had achieved target lipid levels.
Conclusion. Addition of atorvastatin to glucose-lowering and antihypertensive treatment can restore endothelial vasoregulatory function in 6 months in more than half of new-onset type 2 diabetic patients. Maximal effect of combined therapy with atorvastatin is obtained at early stages of diabetes mellitus and at target lipid levels achievement.

About the Authors

G. A. Batrak
Ivanovo State Medical Academy, Ivanovo
Russian Federation
MD, PhD, Assistant of Chair of Therapy and Endocrinology, Ivanovo SMA


S. E. Miasoedova
Ivanovo State Medical Academy, Ivanovo
Russian Federation
MD, PhD, Prof., Head of the same Chair


O. I. Kelesh
Municipal Clinical Hospital №4, Ivanovo
Russian Federation
MD, Department of Functional Diagnostics, MCH № 4


References

1. Dedov I.I. Diabetes mellitus: the development of technology in the diagnosis, treatment and prevention (plenary lecture). Sakharnyy Diabet 2010;3(48):6-13. Russian (Дедов И.И. Сахарный диабет: развитие технологий в диагностике, лечении и профилактике (пленарная лекция). Сахарный диабет 2010;3(48):6-13).

2. Aleksandrov A.A. Diabetes mellitus and coronary heart disease: an unsolved mystery sulfonamides. Consilium Medicum 2001;1(10):500-502. Russian (Александров А.А. Сахарный диабет и ишемическая болезнь сердца: неразгаданная тайна сульфаниламидов. Consilium Medicum 2001;1(10):500-502).

3. Balabolkin M.I., Klebanova E.M., Kreminskaya V.M. The pathogenesis and mechanisms of development of angiopathy in diabetes. Kardiologiia 2000;40(10):74-87. Russian (Балаболкин М.И., Клебанова Е.М., Креминская В.М. Патогенез и механизмы развития ангиопатий при сахарном диабете. Кардиология 2000;40(10):74-87).

4. Susekov A.V., Rozhkova T.A., Tripoten' M.I.i dr. FARVATER randomized study: Part II. The effect of atorvastatin on endothelial function, extensibility and stiffness of the vascular wall. Cardiovascular Therapy and Prevention 2007;6(3):68-75. Russian (Сусеков А.В., Рожкова Т.А., Трипотень М.И.и др. Рандомизированное исследование ФАРВАТЕР: Часть II. Эффект аторвастатина на функцию эндотелия, растяжимость и жесткость сосудистой стенки. Кардиоваскулярная Терапия и Профилактика 2007;6(3):68-75).

5. Karpov R.S., Koshel'skaya O.A., Zhuravleva O.A., i dr. The study of clinical efficacy of lipid-lowering therapy with simvastatin in patients with diabetes treated with combination antihypertensive therapy. Russkiy Meditsinskiy Zhurnal 2005;13(26):1727-1730. Russian (Карпов Р.С., Кошельская О.А., Журавлева О.А., и др. Исследование клинической эффективности гиполипидемической терапии симвастатином у больных сахарным диабетом, получавших комбинированную антигипертензивную терапию. РМЖ 2005;13(26):1727-1730).

6. Ceriello A, Assaloni R, Da Ros R, et al. Effect of Atorvastatin and irbesartan alone and in combination, on postprandial endothelial dysfunction, oxidative stress, and inflammacion in type 2 diabetic patients. Circulation 2005 May 17;111(19):2518-24.

7. Banga, J. D. Aggressive Lipid Lowering Does Not Improve Endothelial Function in Type 2 Diabetes: The Diabetes Atorvastatin Lipid Intervention (DALI) Study: a randomized, double-blind, placebo-controlled trial. Diabetes Care 2002;25:1211-1216.

8. Van Etten RW, de Koning EJ, Honing ML, Stroes ES. et al. Intensive lipid lowering by statin therapy does not improve vasoreactivity in patiens with type 2 diabetes Arterioscler Thromb Vasc Biol 2002;22(5):799-804.

9. Algorithms specialized care to patients with diabetes mellitus. 5th edition. Sakharnyy diabet 2011; suppl 3: 1-72. Russian (Алгоритмы специализированной медицинской помощи больным сахарным диабетом. 5-й выпуск. Сахарный диабет 2011; Приложение 3: 1-72).

10. Diagnosis and correction of disorders of lipid metabolism in the prevention and treatment of ather- osclerosis. Russian Recommendation. IV revision. Cardiovascular Therapy and Prevention 2009;8 (6) suppl 3:1-52. (Диагностика и коррекция нарушений липидного обмена с целью профилактики и лечения атеросклероза. Российские рекомендации. IV пересмотр. Кардиоваскулярная Терапия и Профилактика 2009;8 (6) приложение 3:1-52).

11. Celermayer D.S. Sorensen K.E., Gooch V.M. et al. Non-invasive detection in children and adults at risk of atherosclerosis. Lancet 1992;340:1111-1115.


For citation:


Batrak G.A., Miasoedova S.E., Kelesh O.I. EFFECTS OF ATORVASTATIN ON ENDOTHELIAL DYSFUNCTION IN TYPE 2 DIABETIC PATIENTS WITH DIFFERENT DURATION F THE DISEASE. Rational Pharmacotherapy in Cardiology. 2013;9(4):354-361. https://doi.org/10.20996/1819-6446-2013-9-4-354-361

Views: 508


Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.


ISSN 1819-6446 (Print)
ISSN 2225-3653 (Online)