Atorvastatin for the management of Type 2 diabetic patients with dyslipidaemia. A mid-term (9 months) treatment experience

Abstract

Dyslipidaemia, particularly increased triglycerides (TG) and low HDL-cholesterol (HDL-C), represents an important risk factor for Type 2 diabetes (T2DM) macrovascular complications. Our aim was to evaluate the effects of atorvastatin in a population of T2DM patients according to their cardiovascular risk: evidence of myocardial or coronary lesions (group A); evidence of familiar hypercholesterolaemia (group B); evidence of stable cardiovascular risk (group C). The mean age was 64+/-7 yr, mean disease duration 9.5+/-3 yr, the mean body mass index (BMI) 27.7+/-1.3 kg/m2, mean HbA1c 8+/-0.6%; total cholesterol 256+/-24 mg/dl in group A, 298+/-30 and 244+/-31 in groups B and C, respectively (p<0.05 B vs. A and C). Moreover, mean HDL-C values were about 45+/-7 mg/dl, TG 225+/-20 mg/dl, systolic and diastolic blood pressure 144+/-7 mm Hg and 84+/-8 mm Hg, respectively; fibrinogen values 330+/-23 mg/dl and microalbuminuria 58+/-9 mg/l. Lipid profile improved significantly during the treatment with personalised doses of atorvastatin (generally 10 mg/day) designed to achieve the therapeutic goals: the reduction of total cholesterol, TG (p<0.01), LDL-cholesterol (LDL-C) (p<0.01) and an increase of HDL-C were measured. The treatment with atorvastatin induced significant reduction of microalbuminuria and fibrinogen levels (p<0.01). Moreover, in the subgroup of patients with hypertension, diastolic blood pressure values were reduced without modification of antihypertensive treatment. This preliminary study suggests that the management of hypercholesterolaemia with atorvastatin in T2DM patients may be useful both for the primary and secondary prevention of chronic complications of T2DM.