SIMVASTATIN IN NON-INSULIN-DEPENDENT DIABETES-MELLITUS - EFFECT ON SERUM-LIPIDS, LIPOPROTEINS AND HEMOSTATIC MEASURES

Citation
M. Farrer et al., SIMVASTATIN IN NON-INSULIN-DEPENDENT DIABETES-MELLITUS - EFFECT ON SERUM-LIPIDS, LIPOPROTEINS AND HEMOSTATIC MEASURES, Diabetes research and clinical practice, 23(2), 1994, pp. 111-119
Citations number
38
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Gastroenterology & Hepatology","Endocrynology & Metabolism
ISSN journal
0168-8227
Volume
23
Issue
2
Year of publication
1994
Pages
111 - 119
Database
ISI
SICI code
0168-8227(1994)23:2<111:SIND-E>2.0.ZU;2-2
Abstract
The clinical efficacy of the 3-hydroxy-3-methyl-glutaryl-coenzyme A (H MGCoA) reductase inhibitor simvastatin in the treatment of hypercholes terolaemia in non-insulin-dependent diabetes (NIDDM), was examined in a double-blind placebo-controlled study of 6 months in 70 patients wit h NIDDM (age 25-70 years), of whom 57 were randomised to placebo (29 p atients) or simvastatin for 6 months, following a 3-month run-in on di et. Patients were hypercholesterolaemic (7.8 (7.6-8.0) (mean (95% conf idence intervals)) mmol/l simvastatin vs. 8.0 (7.7-8.5) mmol/l placebo ) and mildly hypertriglyceridaemic (2.6 (2.2-3.0) simvastatin vs. 2.9 (2.3-3.5) placebo). Other lipid measures and estimates of glycaemic co ntrol and haemostasis were similar in both groups. There were no signi ficant changes in lipids, haemostatic factors, or measures of glycaemi c control in the placebo treatment group. Conversely by the end of 24 weeks, simvastatin produced a 28% reduction in cholesterol (to 5.6 (5. 0-6.2) mmol/l (P < 0.001)), a 38% reduction in LDL cholesterol (from 5 .5 (5.4-5.6) mmol/l to 3.4 (2.8-4.0) mmol/l, P < 0.001), a 15% reducti on in triglyceride (to 2.2 (1.8-2.6) mmol/l, P < 0.05, and a 9% rise i n HDL (from 1.16 (1.07-1.25) to 1.23 (1.14-1.32) mmol/l, P < 0.05). Im provements in apolipoprotein B (ape B) (-28%, P < 0.001), the LDL chol esterol to apo B ratio (-20%, P < 0.001), and apo Al (+15%, P < 0.001) were recorded. There were no effects upon fibrinogen, factor VII acti vity, factor VIII activity, or measures of glycaemic control (fasting glucose, insulin, C-peptide, or HbA(1)). Simvastatin is an effective t reatment for hypercholesterolaemia in NIDDM with normal or mildly elev ated triglycerides, which is well tolerated and has no adverse effect upon glycaemic control. Simvastatin may additionally reduce triglyceri des and improve the abnormality of LDL composition which is characteri stic of hyperlipidaemic NIDDM.