The effect of simvastatin on triglyceride-rich lipoproteins in patients with type 2 diabetic dyslipidemia: a SILHOUETTE Trial Sub-study
| Autor: | Adrian S. Dobs, Joanne Palmisano, Michael Miller, Wendy P. Battisti, Zhong Yuan |
|---|---|
| Rok vydání: | 2006 |
| Předmět: |
Male
Simvastatin medicine.medical_specialty Small dense ldl Cholesterol VLDL Type 2 diabetes Diabetic dyslipidemia chemistry.chemical_compound Double-Blind Method Diabetes mellitus Internal medicine medicine Humans In patient Triglycerides Aged Dyslipidemias Triglyceride business.industry nutritional and metabolic diseases General Medicine Middle Aged medicine.disease Crossover study Treatment Outcome Endocrinology Diabetes Mellitus Type 2 chemistry Female lipids (amino acids peptides and proteins) business medicine.drug |
| Zdroj: | Current Medical Research and Opinion. 22:343-350 |
| ISSN: | 1473-4877 0300-7995 |
| DOI: | 10.1185/030079906x80521 |
| Popis: | To determine if simvastatin effectively decreases the elevated levels of triglyceride (TG), TG-rich lipoproteins, and small, dense LDL particles, which are characteristic of diabetic dyslipidemia.We conducted a prespecified analysis from a double-blind, placebo-controlled, randomized, 6-week crossover trial in patients with type 2 diabetes and low HDL-C (40 mg/dL). Each patient was randomized to 1 of 6 possible treatment arms; each patient received simvastatin 80 mg, simvastatin 40 mg, and placebo over 3 periods. We used the validated vertical auto profile (VAP) method to directly assess TG-rich lipoproteins and LDL subclasses. We assessed the efficacy of simvastatin to improve the lipoprotein profile in adult men (71%) and women (29%) (n = 151) with stable type 2 diabetes (HbA1C9%), LDL-C100 mg/dL, HDL-C40 mg/dL, and fasting TG level150 and700 mg/dL (median = 273 mg/dL).Percentage change from baseline in IDL and VLDL (TG-rich lipoproteins), LDL subclasses, and additional lipoproteins at the end of each 6-week treatment interval; percentage of patients who reached NCEP ATP III non-HDL goal of130 mg/dL by the end of each 6-week period.Both simvastatin 80 mg and 40 mg significantly reduced VLDL-C, VLDL3, and IDL, as well as the four LDL subclasses measured with VAP, compared with placebo. Simvastatin 80 mg, compared with simvastatin 40 mg, provided additional efficacy. With simvastatin 80 mg, 77.2% of patients not at their non-HDL-C goal of130 mg/dL at study baseline reached goal, compared with 65.7% following simvastatin 40 mg treatment, and 2.2% following placebo.Treatment with simvastatin effectively reduced the elevated levels of TG-rich lipoproteins and improved LDL composition in patients with type 2 diabetes. A large percentage of these patients attained the NCEP ATP III non-HDL-C goal of130 mg/dL, which demonstrates the improvement of the atherogenic profile in these patients. |
| Databáze: | OpenAIRE |
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