Switching fibrate to statin in type 2 diabetic patients: Consequences on lipid profile
| Autor: | Jean-Philippe Kevorkian, J. Peynet, T. Meas, Marie Virally, Marie Laloi-Michelin, V. Giraudeaux, Pierre-Jean Guillausseau |
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| Rok vydání: | 2009 |
| Předmět: |
Adult
Male medicine.medical_specialty Statin medicine.drug_class Atorvastatin Fibrate Clofibric Acid chemistry.chemical_compound Diabetes mellitus Internal medicine Internal Medicine medicine Humans Pyrroles Prospective Studies Prospective cohort study Triglycerides Aged Dyslipidemias medicine.diagnostic_test business.industry Cholesterol Cholesterol HDL Cholesterol LDL Middle Aged medicine.disease Endocrinology Diabetes Mellitus Type 2 chemistry Heptanoic Acids Female lipids (amino acids peptides and proteins) Hydroxymethylglutaryl-CoA Reductase Inhibitors business Lipid profile Dyslipidemia Follow-Up Studies medicine.drug |
| Zdroj: | European Journal of Internal Medicine. 20:197-200 |
| ISSN: | 0953-6205 |
| DOI: | 10.1016/j.ejim.2008.06.009 |
| Popis: | Interest of statins in terms of morbid-mortality reduction in primary and secondary prevention in type 2 diabetic patients has broadly been proven in recent studies, while evidence for fibrates preventive effect is considerably weaker. HMGCoA reductase inhibitors are known to decrease low density lipoprotein cholesterol (LDL C) in a greater extension than triglycerides (TG). In type 2 diabetic patients, the dyslipidemic profile is commonly associated with reduced high-density lipoproteins (HDL C), increased TG and normal or mildly elevated LDL C. Patients and methods Type 2 diabetic outpatients ( n = 45) treated with fibrate with or without history of cardiovascular disease were included. Mean age was 57.7±13.2 yr, sex ratio was 16/39 (F/M), and BMI was 29.3±4.4 kg/m 2 . Non-inclusion criteria were TG≥3.5 g/L and intolerance to statins or a combined lowering lipid therapy. Serum lipid profile, HbA 1c and creatin kinase (CK) were assessed under treatment with fibrate, then after a 3-month wash-out period, and after a 6-month treatment with a low dose of atorvastatin (10 mg/day). Results After a 3-month wash-out period, total cholesterol (TC) was 1.98±0.31 g/L (m±SD), TG 1.63±1.09 g/L, HDL C 0.46±0.12 g/L, and LDL C 1.22±0.31 g/L. Comparing lipid profile with atorvastatin vs fibrate, we observed a significant decrease in TC and LDL C (1.56 vs 1.79 g/L P =0.001, and 0.84 vs 1.09 g/L, P =0.001, respectively). No significant difference between treatments was observed for TG (1.35 vs 1.17 g/L, P =0.06), and HDL C (0.44 vs 0.48 g/L, P =0.15). When treated with atorvastatin, 90% of patients achieved a LDL C P = 0.001). HbA 1c remained about 7.6±1.5%, and CK in the normal range. Conclusion In well-controlled type 2 diabetic patients previously treated with fibrate, short-term (6 months) treatment with low-dose atorvastatin (10 mg/day) improves TC and LDL C levels, without any alteration in TG and HDL C levels. |
| Databáze: | OpenAIRE |
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