Effects of patient-tailored atorvastatin therapy on ameliorating the levels of atherogenic lipids and inflammation beyond lowering low-density lipoprotein cholesterol in patients with type 2 diabetes

Jang Won Son, Dong Jun Kim, Chang Beom Lee, Seungjoon Oh, Kee Ho Song, Chan Hee Jung, Ji Oh Mok, Jong Hwa Kim, Min Kyong Moon, Kyung Mook Choi, Jae Hyoung Cho, Sung Hee Choi, Soo Kyung Kim, Kang Seo Park, Hye Soon Kim, In Joo Kim, Young Il Kim, Hae Jin Kim, Sang Yong Kim, Sungrae Kim

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

Aims/Introduction: Recently, patient-tailored statin therapy was proven effective for achieving target low-density lipoprotein (LDL) cholesterol levels. It is unclear, however, whether this therapeutic modality would be effective for atherogenic lipid profiles and inflammation in patients with type 2 diabetes. Materials and Methods: The present study was an 8-week, multicenter, single-step titration trial of patient-tailored atorvastatin therapy (10, 20 and 40 mg) according to baseline LDL cholesterol levels in 440 patients with type 2 diabetes. We measured the LDL particle size by polyacrylamide gel electrophoresis, and used high-sensitivity C-reactive protein (hsCRP) and adiponectin as surrogate markers of inflammation. Results: In the intention-to-treat analysis, 91% of the patients achieved their LDL cholesterol targets (<2.6 mmol/L) at week 8. There were significant reductions at week 8 in total cholesterol, triglycerides, non-high-density lipoprotein cholesterol (HDL) cholesterol, and the total cholesterol:HDL cholesterol ratio compared with the baseline values for all of the doses. The mean LDL particle size was significantly increased, and the small, dense LDL cholesterol levels were decreased in a dose-dependent manner over the study period. In addition, the hsCRP levels were decreased in those high-risk patients with baseline hsCRP levels over 3 mg/L (P < 0.001), and the adiponectin levels tended to increase with all of the doses (P = 0.004) at 8 weeks. Conclusions: Patient-tailored atorvastatin therapy based on LDL cholesterol at baseline was effective in ameliorating atherogenic LDL particle size and inflammation, in addition to achieving the target LDL cholesterol level without an undesirable effect on glycemic control in patients with type 2 diabetes. This trial was registered with ClinicalTrials.gov (no. NCT01239849).

Original languageEnglish
Pages (from-to)466-474
Number of pages9
JournalJournal of Diabetes Investigation
Volume4
Issue number5
DOIs
Publication statusPublished - 2013 Sep 1

Fingerprint

LDL Cholesterol
Type 2 Diabetes Mellitus
Inflammation
Lipids
Cholesterol
LDL Lipoproteins
Particle Size
C-Reactive Protein
Adiponectin
Therapeutics
Hydroxymethylglutaryl-CoA Reductase Inhibitors
Intention to Treat Analysis
Atorvastatin Calcium
HDL Cholesterol
Polyacrylamide Gel Electrophoresis
Triglycerides
Biomarkers

Keywords

  • Atorvastatin
  • Low-density lipoprotein cholesterol
  • Type 2 diabetes mellitus

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism

Cite this

Effects of patient-tailored atorvastatin therapy on ameliorating the levels of atherogenic lipids and inflammation beyond lowering low-density lipoprotein cholesterol in patients with type 2 diabetes. / Son, Jang Won; Kim, Dong Jun; Lee, Chang Beom; Oh, Seungjoon; Song, Kee Ho; Jung, Chan Hee; Mok, Ji Oh; Kim, Jong Hwa; Moon, Min Kyong; Choi, Kyung Mook; Cho, Jae Hyoung; Choi, Sung Hee; Kim, Soo Kyung; Park, Kang Seo; Kim, Hye Soon; Kim, In Joo; Kim, Young Il; Kim, Hae Jin; Kim, Sang Yong; Kim, Sungrae.

In: Journal of Diabetes Investigation, Vol. 4, No. 5, 01.09.2013, p. 466-474.

Research output: Contribution to journalArticle

Son, JW, Kim, DJ, Lee, CB, Oh, S, Song, KH, Jung, CH, Mok, JO, Kim, JH, Moon, MK, Choi, KM, Cho, JH, Choi, SH, Kim, SK, Park, KS, Kim, HS, Kim, IJ, Kim, YI, Kim, HJ, Kim, SY & Kim, S 2013, 'Effects of patient-tailored atorvastatin therapy on ameliorating the levels of atherogenic lipids and inflammation beyond lowering low-density lipoprotein cholesterol in patients with type 2 diabetes', Journal of Diabetes Investigation, vol. 4, no. 5, pp. 466-474. https://doi.org/10.1111/jdi.12074
Son, Jang Won ; Kim, Dong Jun ; Lee, Chang Beom ; Oh, Seungjoon ; Song, Kee Ho ; Jung, Chan Hee ; Mok, Ji Oh ; Kim, Jong Hwa ; Moon, Min Kyong ; Choi, Kyung Mook ; Cho, Jae Hyoung ; Choi, Sung Hee ; Kim, Soo Kyung ; Park, Kang Seo ; Kim, Hye Soon ; Kim, In Joo ; Kim, Young Il ; Kim, Hae Jin ; Kim, Sang Yong ; Kim, Sungrae. / Effects of patient-tailored atorvastatin therapy on ameliorating the levels of atherogenic lipids and inflammation beyond lowering low-density lipoprotein cholesterol in patients with type 2 diabetes. In: Journal of Diabetes Investigation. 2013 ; Vol. 4, No. 5. pp. 466-474.
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AU - Kim, Dong Jun

AU - Lee, Chang Beom

AU - Oh, Seungjoon

AU - Song, Kee Ho

AU - Jung, Chan Hee

AU - Mok, Ji Oh

AU - Kim, Jong Hwa

AU - Moon, Min Kyong

AU - Choi, Kyung Mook

AU - Cho, Jae Hyoung

AU - Choi, Sung Hee

AU - Kim, Soo Kyung

AU - Park, Kang Seo

AU - Kim, Hye Soon

AU - Kim, In Joo

AU - Kim, Young Il

AU - Kim, Hae Jin

AU - Kim, Sang Yong

AU - Kim, Sungrae

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N2 - Aims/Introduction: Recently, patient-tailored statin therapy was proven effective for achieving target low-density lipoprotein (LDL) cholesterol levels. It is unclear, however, whether this therapeutic modality would be effective for atherogenic lipid profiles and inflammation in patients with type 2 diabetes. Materials and Methods: The present study was an 8-week, multicenter, single-step titration trial of patient-tailored atorvastatin therapy (10, 20 and 40 mg) according to baseline LDL cholesterol levels in 440 patients with type 2 diabetes. We measured the LDL particle size by polyacrylamide gel electrophoresis, and used high-sensitivity C-reactive protein (hsCRP) and adiponectin as surrogate markers of inflammation. Results: In the intention-to-treat analysis, 91% of the patients achieved their LDL cholesterol targets (<2.6 mmol/L) at week 8. There were significant reductions at week 8 in total cholesterol, triglycerides, non-high-density lipoprotein cholesterol (HDL) cholesterol, and the total cholesterol:HDL cholesterol ratio compared with the baseline values for all of the doses. The mean LDL particle size was significantly increased, and the small, dense LDL cholesterol levels were decreased in a dose-dependent manner over the study period. In addition, the hsCRP levels were decreased in those high-risk patients with baseline hsCRP levels over 3 mg/L (P < 0.001), and the adiponectin levels tended to increase with all of the doses (P = 0.004) at 8 weeks. Conclusions: Patient-tailored atorvastatin therapy based on LDL cholesterol at baseline was effective in ameliorating atherogenic LDL particle size and inflammation, in addition to achieving the target LDL cholesterol level without an undesirable effect on glycemic control in patients with type 2 diabetes. This trial was registered with ClinicalTrials.gov (no. NCT01239849).

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KW - Atorvastatin

KW - Low-density lipoprotein cholesterol

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