Effect of Simvastatin and Fenofibrate on Cytokine Release and Systemic Inflammation in Type 2 Diabetes Mellitus With Mixed Dyslipidemia
Effect of Simvastatin and Fenofibrate on Cytokine Release and Systemic Inflammation in Type 2 Diabetes Mellitus With Mixed Dyslipidemia
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DOI：
10.1016/j.amjcard.2010.11.023
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发表时间：
2011-04-01
影响因子：
2.8
通讯作者：
Okopien, Boguslaw
中科院分区：
文献类型：
--
作者：
Krysiak, Robert;Gdula-Dymek, Anna;Okopien, Boguslaw
我们研究的目的是比较辛伐他汀和非诺贝特治疗对人类单核细胞和淋巴细胞的分泌功能以及对 2 型糖尿病全身炎症的影响，并评估它们的联合用药是否优于仅使用其中一种药物的治疗。 196 名新近诊断且既往未经治疗的 2 型糖尿病和混合性血脂异常患者，在整个研究过程中均遵守生活方式干预并接受二甲双胍治疗，以双盲方式随机接受辛伐他汀（40 毫克）、非诺贝特（200 毫克）、辛伐他汀加非诺贝特或安慰剂治疗，为期 90 天。主要结果测量是单核细胞和淋巴细胞促炎细胞因子的释放以及C反应蛋白的血浆水平。一百九十名患者完成了这项研究。辛伐他汀和非诺贝特减少了单核细胞释放的肿瘤坏死因子-a、白细胞介素-1β、白细胞介素-6和单核细胞趋化蛋白-1，以及淋巴细胞释放的白细胞介素-2、干扰素-γ和肿瘤坏死因子-α，同时血浆C反应蛋白水平降低。非诺贝特的抗炎作用与胰岛素敏感性的改善部分相关。如果这两种药物一起给药，则抑制淋巴细胞的作用更强，但不抑制单核细胞的作用更强。总之，辛伐他汀和非诺贝特对人单核细胞和淋巴细胞的分泌功能以及对混合性血脂异常的 2 型糖尿病受试者的全身炎症表现出相似的作用。这种作用可能与预防新诊断糖尿病血脂异常的二甲双胍和饮食治疗受试者的血管并发症具有临床相关性。 (C) 2011 Elsevier Inc. 保留所有权利。 （美国心脏杂志 2011 年；107：1010-1018）
The aim of our study was to compare the effect of simvastatin and fenofibrate treatment on the secretory function of human monocytes and lymphocytes and on systemic inflammation in type 2 diabetes and to assess whether their coadministration is superior to treatment with only 1 of these drugs. One hundred ninety-six adult patients with recently diagnosed and previously untreated type 2 diabetes and mixed dyslipidernia, complying throughout the study with lifestyle intervention and treated with metformin, were randomized in a double-blind fashion to receive simvastatin (40 mg), fenofibrate (200 mg), simvastatin plus fenofibrate, or placebo for 90 days. Main outcome measurements were monocyte and lymphocyte release of proinflammatory cytokines and plasma levels of C-reactive protein. One hundred ninety patients completed the study. Simvastatin and fenofibrate decreased monocyte release of tumor necrosis factor-a, interleukin-1 beta, interleukin-6, and monocyte chemoattractant protein-1 and lymphocyte release of interleukin-2, interferon-gamma, and tumor necrosis factor-alpha, which was accompanied by a decrease in plasma C-reactive protein levels. Anti-inflammatory effects of fenofibrate partly correlated with the improvement in insulin sensitivity. Lymphocyte-suppressing, but not monocyte-suppressing, effect was stronger if these 2 agents were administered together. In conclusion, simvastatin and fenofibrate exhibit a similar effect on the secretory function of human monocytes and lymphocytes and on systemic inflammation in type 2 diabetic subjects with mixed dyslipidemia. This effect may be clinically relevant in the prevention of vascular complications in metformin- and diet-treated subjects with newly diagnosed diabetic dyslipidemia. (C) 2011 Elsevier Inc. All rights reserved. (Am J Cardiol 2011;107:1010-1018)