Soran H, et al. - In a study sample of high-risk type 2 diabetes (T2DM) patients, researchers not only compared the impacts of high and moderate-intensity atorvastatin treatment on lipoprotein metabolism and inflammatory markers but also investigated how frequently treatment goals were met. They found that with high-dose atorvastatin treatment, non-high density lipoprotein cholesterol (HDL-C) therapeutic goals were achieved and low-density lipoprotein (LDL)-related parameters were modified in a more effective manner. Data indicated that recommended apolipoprotein B100 (apoB) treatment targets may require revision. No change in HDL functionality was visible, despite an observed increase in adiponectin and decrease in serum amyloid A (SAA).

Methods

• Researchers randomised patients with T2DM and albuminuria (urinary albumin:creatinine ratio >5mg/mmol, total cholesterol <7mmol/l, proteinuria <2g/day, creatinine <200μmol/l) to receive atorvastatin 10mg (n=59) or 80mg (n=60) daily.
• Baseline and one-year follow-up data were obtained and analyzed.

Results

• A high cardiovascular disease (CVD) risk was observed in patients (observed combined mortality and non-fatal CVD annual event rate 4.8%).
• Findings demonstrated that the non-high density lipoprotein cholesterol (HDL-C) goal of <2.6mmol/l was achieved in 72% of participants receiving high-dose atorvastatin, but only in 40% on low-dose (P<0.005).
• Researchers found that the proportion achieving apolipoprotein B (apoB) <0.8g/l on high and low-dose atorvastatin was 82% and 70% respectively (NS).
• A marked decrease was noted in total cholesterol, triglycerides, low-density lipoprotein cholesterol (LDL-C), non-HDL-C, oxidised-LDL, apoB, glycapoB, apolipoprotein E and lipoprotein-associated phospholipase A2, more so in participants on high-dose atorvastatin.
• Data also reported an increase in adiponectin and decrease in serum amyloid A (SAA), without dose dependency.
• Additionally, results revealed that neither dose induced marked alterations in HDL-C, cholesterol efflux, high-sensitivity C-reactive protein, glycated haemoglobin, serum paraoxonase-1, lecithin:cholesterol acyl transferase or cholesteryl ester transfer protein.