Differential effect of atorvastatin and fenofibrate on plasma oxidized low-density lipoprotein, inflammation markers, and cell adhesion molecules in patients with type 2 diabetes mellitus
Differential effect of atorvastatin and fenofibrate on plasma oxidized low-density lipoprotein, inflammation markers, and cell adhesion molecules in patients with type 2 diabetes mellitus
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DOI：
10.1016/j.metabol.2007.10.014
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发表时间：
2008-03-01
影响因子：
9.8
通讯作者：
Couture, Patrick
中科院分区：
文献类型：
--
作者：
Hogue, Jean-Charles;Lamarche, Benoit;Couture, Patrick
2型糖尿病与血浆甘油三酯水平升高、高密度脂蛋白胆固醇降低和心血管疾病的高发病率相关。羟甲基戊二酰辅酶A还原酶抑制剂和贝特类药物常用于治疗糖尿病血脂异常，但它们对动脉粥样硬化相关炎症过程的具体影响仍有待充分表征。这项2组平行研究的目的是研究阿托伐他汀20 mg/d单独给药（n = 19）或微粉化非诺贝特200 mg/d单独给药（n = 19）6周对2型糖尿病伴显著高脂血症受试者炎症、细胞粘附和氧化标志物的不同影响。除了预期的血脂水平变化外，阿托伐他汀还降低了血浆C反应蛋白水平（-26.9%，P = .004），可溶性细胞间粘附分子1（-5.4%，P = .03），可溶性血管细胞粘附分子1（-4.4%，P = .008），sE-选择素（-5.7%，P = .02），基质金属蛋白酶9（-39.6%，P = .04）、分泌型磷脂酶A（2）（sPLA（2））（-14.8%，P = .04）和氧化型低密度脂蛋白（-38.4%，P < .0001）。另一方面，非诺贝特对C-反应蛋白水平无显著影响，仅与血浆sE-选择素水平降低（-6.0%，P = .04）和血浆sPLA水平升高（+22.5%，P = .004）相关。这些结果表明，阿托伐他汀能够有效地降低2型糖尿病患者的炎症、氧化和单核细胞粘附，而非诺贝特仅降低sE-选择素水平，并与sPLA（2）水平升高相关。(C)2008年爱思唯尔公司All rights reserved.
Type 2 diabetes mellitus is associated with elevated plasma triglyceride levels, low high-density lipoprotein cholesterol, and a high incidence of cardiovascular disease. Hydroxymethylglutaryl-coenzyme A reductase inhibitors and fibrates are frequently used in the treatment of diabetic dyslipidemia, but their specific impact on the inflammation processes involved in atherosclerosis remains to be fully characterized. The objective of this 2-group parallel study was to investigate the differential effects of a 6-week treatment with either atorvastatin 20 mg/d alone (n = 19) or micronized fenofibrate 200 mg/d alone (n = 19) on inflammation, cell adhesion, and oxidation markers in type 2 diabetes mellitus subjects with marked hypertriglyceridemia. In addition to the expected changes in lipid levels, atorvastatin decreased plasma levels of C-reactive protein (-26.9%, P = .004), soluble intercellular adhesion molecule 1 (-5.4%, P = .03), soluble vascular cell adhesion molecule 1 (-4.4%, P = .008), sE-selectin (-5.7%, P = .02), matrix metalloproteinase 9 (-39.6%, P = .04), secretory phospholipase A(2) (sPLA(2)) (-14.8%, P = .04), and oxidized low-density lipoprotein (-38.4%, P < .0001). On the other hand, fenofibrate had no significant effect on C-reactive protein levels and was associated with reduced plasma levels of sE-selectin only (-6.0%, P = .04) and increased plasma levels of sPLA(2) (+22.5%, P = .004). These results suggest that atorvastatin was potent to reduce inflammation, oxidation, and monocyte adhesion in type 2 diabetes mellitus subjects with marked hypertriglyceridemia, whereas fenofibrate decreased sE-selectin levels only and was associated with an elevation of sPLA(2) levels. (C) 2008 Elsevier Inc. All rights reserved.