| Popis: |
Aim: The aim of the study was to investigate the role of statin, aspirin and angiotensin-converting enzyme (ACE) inhibitor therapy in the development of atherosclerosis via their effect on the reduction in C-reactive protein (CRP) and homocysteine (HCY). Methods: A total of 243 type 2 diabetic patients were studied during a 1-year follow-up period. Patients were randomized to receive atorvastatin (n = 59), simvastatin (n = 64), pravastatin (n = 38), or ACEinhibitor lisinopril (n = 43). The control group included 39 patients. CRP, HCY, atherogenic index of plasma (AIP), body mass index (BMI), pulse pressure (PP) and albumin excretion rate (AER) were determined. The patients were assigned to groups based on AER/mg/24 h/ (300), PP (65) and BMI (30). Results: ANOVA revealed significant differences in initial CRP and AIP (P = 0.01 and P = 0.041, respectively) according to AER and BMI (both P < 0.001), and in HCY and AIP (both P < 0.001) according to PP. Multiple linear regression for CRP, HCY, age, diabetes duration, BMI, AIP, AER and PP was significant (P < 0.01) and showed BMI and AIP to be independent predictors of CRP, and age, AER and BMI independent predictors of HCY (P < 0.05). CRP was significantly reduced in the groups treated with atorvastatin (P < 0.001), simvastatin (P = 0.049) and lisinopril (P = 0.012). HCY was significantly reduced in the simvastatinand pravastatin-treated groups (P = 0.015 vs. P = 0.002), and AIP and PP were significantly reduced in the simvastatin- and atorvastatin-treated groups (both P < 0.01). A significant reduction (P < 0.005) in AER and PP was revealed in the lisinopril group. Conclusions: BMI was an independent predictor of inflammatory markers, whereas ACE-inhibitors and statins had a beneficial effect on blood pressure and lipid profile. The latter can attenuate inflammation by reducing CRP and HCY and, consequently, together with body weight reduction, delay the development of atherosclerosis. |
