Comparison of effects of carbohydrate metabolism compensation and atorvastatin treatment on lipid metabolism and C-reactive protein in type 2 diabetes mellitus

Full Text


Aim. To compare effects of atorvastatin treatment and carbohydrate metabolism compensation on lipid spectrum and a C-reactive protein (CRP) level in patients with type 2 diabetes mellitus (DM).
Material and methods. The lipid spectrum was studied in a random sample of 165 patients (66 males, 99 females) with type 2 DM (age median 57 years, duration of the disease 7 years). Out of this sample 26 patients with LDLP cholesterol > 3 mmol/l were randomized into 2 groups. The study group received 20 mg/day atorvastatin for 3 months, the control group received no inhibitors of GMG-Coa-reductase. The patients' blood was tested for glycosylated hemoglobin, aminotransferase, creatinphosphokinase, total, HDLP, LDLP cholesterol.
Results. Changes in the lipid spectrum were detected in 98.2% patients, 42.4% of them had combined dyslipidemia: elevated total cholesterol (TC), LDLP cholesterol, triglycerides (TG) and low HDLP cholesterol. After 3 months of therapy both groups demonstrated the same significant lowering of HbA1c. The control group had also elevated level of HDLP cholesterol, unchanged levels of TC, LDLP cholesterol, TG. 3-month therapy with atorvastatin lowered TC from 6.41 to 4.76 mmol/l, LDLP cholesterol from 4.19 to 1.87 mmol/l, TG from 2.69 to 1.62 mmol/l, apo B from 1.64 to 1.13 mg/dl, raised HDLP from 0.99 to 1.21 mmol/l (p < 0.05). CRP fell from 5.65 to 2.33 mg/dl (p = 0.026) irrespective of carbohydrate metabolism compensation (CRP in the control group did not change).
Conclusion. More than 98% type 2 diabetics have atherognic impairment of the lipid spectrum. Atorvastatin produces an antiatherogenic effect due to both improvement of the lipid metabolism and CRP level reduction irrespective of the degree of compensation of carbohydrate metabolism in type 2 DM.


  1. Laakso M., Lehto S. Epidemiology of macrovascular disease in diabetes. Diabet. Rev. 1997; 5: 294-315.
  2. National Institute of Diabetes and Digestive and Kidney Disease: Diabetes in America. 2nd ed. 1995.
  3. Kannel W. B. Lipids, diabetes and coronary heat disease: insights from Framingam Study. Am. Heart J. 1985; 110: 1100- 1107.
  4. Stamler J., Vacaro O., Neaton J. D. et al. Diabetes, other risk factors, and 120yr cardiovascular mortality for men screened in the Multiole Risk Factor Intervention Trial. Diabet. Care. 1993; 16L: 433-444.
  5. UK Prospective Diabetes Study (UKPDS) Group. Risk factors for coronary artery disease in non-insulin dependent diabetes mellitus. Diabet. Care. 2002; 25 (suppl.): 74-77.
  6. Assmann G., Schulte H. Identification of individuals at high risk for myocardial infarction. Atherosclerosis. 1994; 110: 11-21.
  7. Дедов И. И., Шестакова М. В., Максимова М. А. Федеральная целевая программа "Сахарный диабет": (Метод. рекомендации). М.; 2002.
  8. European Diabetes Policy Group. Guidelines for the desktop guide to Type 2 Diabetes Mellitus. International Diabetes Federation European Region. Geneva, 1998-1999.
  9. Goldberg R. B., Mellies M. J., Sacks F. M. et al. Cardiovascular events and their reduction with pravastatin in diabetic and glucose-intolerant myocardial infarction survivors with average cholesterol levels: subgroup analysis in the Cholesterol And Recurrent Events (CARE) Trial. Circulation. 1998; 98: 2513- 2519.
  10. Haffner S. M., Alexander C. M., Cook T. J. et al. Reduced coronary events in simvastatin-treated patients with coronary heart disease and diabetes or impaired fasting glucose levels. Arch. Intern. Med. 1999; 159: 2661-2667.
  11. Heart Protection Study Collaborative Group. MRC/BHF Heart Protection Study of cholesterol lowering with simvastatin 5963 people with diabetes: randomized placebo-controlled trial. Lancet 2003; 361: 2005-2016.
  12. Pyorala K., Pederson T. R., Kjekshus J. et al. Cholesterol lowering with simvastatin improves prognosis in diabetic patients with coronary heart disease: a subgroup analysis of the Scandinavian Simvastatin Survival Study (4S). Diabet. Care 1997; 20: 614-620. 13. The Long-term Intervention of Pravastatin on Ischaemic Disease (LIPID) Study Group. Prevention of cardiovascular events and death with pravastatin in patient with coronary heart disease and a broad range of initial cholesterol levels. N. Engl. J. Med. 1998; 339: 1349-1357.
  13. Урусбиева Д. М., Гиляревский С. Р., Даурбекова Л. В. Возможности медикаментозной коррекции факторов риска сердечно-сосудистых заболеваний у больных сахарным диабетом II типа в условиях эндокринологических центров. Рос. кардиол. журн. 2003; 41(3):75-80.
  14. Beaton S. J., Nag S. S., Gunter M. G. et al. Adequacy of glycemic, lipid and blood pressure management in patient with diabetes in a managed care setting. Diabet. Care 2004; 27: 694- 698.
  15. Davis W. A., Knuiman M. V., Hendrie D. et al. Determinants of diabetes-attributable non-blood glucose-lowering medication costs in type 2 diabetes. Diabet. Care 2005; 28: 329-336.
  16. McFarlane I. Control of cardiovascular risk factors in patients with diabetes and hypertension at urban academic medical centers. Diabet. Care 2002; 25: 718-723.
  17. Assmann G., Schulte H. Identification of individuals at high risk for myocardial infarction. Atherosclerosis. 1994; 110: 11-21.
  18. Castelli W. P. Lipids, risk factors and ischemic heart disease. Atherosclerosis 1996; 124 (suppl.): 1-9.
  19. Kannel W. B. Lipids, diabetes and coronary heart disease: insights from Framingam Study. Am. Heart J. 1985; 110: 1100- 1107.
  20. Jones P., Davidson M., Stein E., Bays H., McKenney J., Miller E., Cain V., Blasetto J. Comparison of the efficacy and safety of rosuvastatin versus atorvastatin, simvastatin and pravastatin across doses (STELLAR Trial). Am. J. Cardiol. 2003; 93: 152-160.



Abstract: 164

Article Metrics

Metrics Loading ...


  • There are currently no refbacks.

Copyright (c) 2008 Glinkina I.V., Zilov A.V., Mel'nichenko G.A., Roytman A.P., Il'in A.V., Glinkina I.V., Zilov A.V., Melnichenko G.A., Roitman A.P., Ilyin A.V.

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.

Address of the Editorial Office:

  • Novij Zykovskij proezd, 3, 40, Moscow, 125167

Correspondence address:

  • Novoslobodskaya str 31c4., Moscow, 127005, Russian Federation

Managing Editor:


© 2018-2021 "Consilium Medicum" Publishing house

This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies