Effect of atorvastatin intervention on carotid atherosclerosis in patients with type 2 diabetes mellitus

doi:10.3877/cma.j.issn.1674-0785.2018.03.001

Abstract

Abstract:

Objective

To investigate the effect of atorvastatin intervention on glucose and lipid metabolism, inflammatory cytokine levels, and carotid atherosclerosis in patients with type 2 diabetes mellitus.

Methods

A total of 196 patients with type 2 diabetes mellitus treated at our hospital between January 2015 and December 2016 were collected and divided into either a control group (n=98) or an atorvastatin group (n=98) according to treatment method. The patients in both groups were treated with basic treatment, and the patients in the atorvastatin group were additionally treated with atorvastatin. The changes of glucose metabolism, lipid metabolism, inflammatory cytokine levels, and carotid artery atherosclerosis-related indexes were analyzed and compared between the two groups.

Results

After treatment, FPG, HbA1c, INS, and HOMA-IR levels were not statistically significant between the two groups of patients [(6.42±1.21) mmol/L vs (6.27±1.05) mmol/L, t=0.406, P=0.572; (6.21±0.65)% vs (6.08±0.73)%, t=0.662, P=0.339; (13.04±1.21)% vs (12.83±1.15)%, t=0.316, P=0.606; (3.75±0.27) vs (3.64±0.35), t=0.283, P=0.692), respectively]. TC, TG, and LDL-C were significantly lower and HDL-C was significantly higher in the atorvastatin group than in the control group [(3.18±0.33) vs (4.76±0.39), t=2.738, P=0.009; (1.69±0.14) vs (2.13±0.31), t=3.012, P=0.003; (1.74±0.27) vs (3.08±0.39), t=3.974, P=0.001; (1.26±0.21) vs (1.04±0.15), t=2.458, P=0.014), respectively]. CRP, IL-6, TNF-α, ICAM-1, VCAM-1, and Selectin levels were significantly lower in the atorvastatin group than in the control group [(0.83±0.09) vs (0.92±0.11), t=2.576, P=0.036; (1.83±0.25) vs (2.32±0.36), t=3.119, P=0.025; (33.83±4.15) vs (41.92±6.11), t=3.102, P=0.029; (198.83±14.15) vs (210.92±15.11), t=2.583, P=0.035; (457.83±41.15) vs (501.92±38.11), t=2.104, P=0.043; (20.04±1.91) vs (25.83±2.09), t=2.722, P=0.031), respectively]. IMT, plaque thickness, plaque size, and plaque number were significantly lower in the atorvastatin group than in the control group [(1.05±0.12) mm vs (1.30±0.16) mm, t=3.501, P=0.012; (2.64±0.37) mm vs (3.23±0.55) mm, t=3.164, P=0.019; (0.078±0.021) cm² vs (0.093±0.025) cm², t=4.068, P=0.001; (3.54±0.62) vs (4.23±0.92), t=2.083, P=0.042, respectively]. In multivariate logistic regression analysis, IMT was significantly associated with atorvastatin, HDL-C, TC, TG, LDL, CRP, IL-6, and TNF-α.

Conclusion

Atorvastatin can regulate lipid metabolism and reduce inflammatory cytokine levels and carotid atherosclerosis in patients with type 2 diabetes mellitus.

Key words: Type 2 diabetes mellitus, Atorvastatin, Glucose and lipid metabolism, Inflammatory cytokine levels, Carotid atherosclerosis

Yan Wu, Huaiguo Zhang, Cunfu Liang, Xiangwen Xu, Haiying Fan, Rui Tao, Lingling Wang, Bin Li, Shufa Li. Effect of atorvastatin intervention on carotid atherosclerosis in patients with type 2 diabetes mellitus[J]. Chinese Journal of Clinicians(Electronic Edition), 2018, 12(03): 129-134.

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References 19

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组别	性别（男/女）	年龄（岁）	糖尿病病程（年）	高血压病史（有/无）	SBP（mmHg）	DBP（mmHg）	ALT（U/L）	AST（U/L）	CK（U/L）	LDH（U/L）
对照组	53/45	61.78±5.12	8.15±5.22	66/32	143.55±23.02	97.36±11.33	31.33±12.25	35.87±11.42	135.43±64.69	209.58±89.34
阿托伐他汀组	50/48	62.34±4.87	7.98±4.86	71/27	145.39±27.13	98.93±10.96	34.86±14.13	32.43±12.87	146.74±72.45	217.49±78.32
统计值	χ²=0.184	t=1.422	t=0.502	χ²=0.606	t=1.569	t=0.451	t=1.973	t=0.672	t=0.429	t=0.417
P值	0.668	0.158	0.481	0.436	0.352	0.583	0.294	0.431	0.592	0.629

组别	性别（男/女）	年龄（岁）	糖尿病病程（年）	高血压病史（有/无）	SBP（mmHg）	DBP（mmHg）	ALT（U/L）	AST（U/L）	CK（U/L）	LDH（U/L）
对照组	53/45	61.78±5.12	8.15±5.22	66/32	143.55±23.02	97.36±11.33	31.33±12.25	35.87±11.42	135.43±64.69	209.58±89.34
阿托伐他汀组	50/48	62.34±4.87	7.98±4.86	71/27	145.39±27.13	98.93±10.96	34.86±14.13	32.43±12.87	146.74±72.45	217.49±78.32
统计值	χ²=0.184	t=1.422	t=0.502	χ²=0.606	t=1.569	t=0.451	t=1.973	t=0.672	t=0.429	t=0.417
P值	0.668	0.158	0.481	0.436	0.352	0.583	0.294	0.431	0.592	0.629

组别	FPG（mmol/L）				HbA1c（%）				FINS（mU/L）				HOMA-IR
组别	治疗前	治疗后	t值	P值	治疗前	治疗后	t值	P值	治疗前	治疗后	t值	P值	治疗前	治疗后	t值	P值
对照组	9.56±1.08	6.27±1.05	5.655	0.001	8.56±0.82	6.08±0.73	3.454	0.003	16.35±1.47	12.83±1.15	3.258	0.005	7.12±0.83	3.64±0.35	3.434	0.002
阿托伐他汀组	9.78±1.33	6.42±1.21	4.968	0.001	8.70±0.94	6.21±0.65	3.569	0.002	16.72±1.68	13.04±1.21	3.392	0.004	7.24±0.78	3.75±0.27	3.973	0.001
t值	0.336	0.406	?	?	0.553	0.662	?	?	0.316	0.418	?	?	0.442	0.283	?	?
P值	0.625	0.572	?	?	0.487	0.339	?	?	0.606	0.551	?	?	0.520	0.692	?	?

组别	FPG（mmol/L）				HbA1c（%）				FINS（mU/L）				HOMA-IR
组别	治疗前	治疗后	t值	P值	治疗前	治疗后	t值	P值	治疗前	治疗后	t值	P值	治疗前	治疗后	t值	P值
对照组	9.56±1.08	6.27±1.05	5.655	0.001	8.56±0.82	6.08±0.73	3.454	0.003	16.35±1.47	12.83±1.15	3.258	0.005	7.12±0.83	3.64±0.35	3.434	0.002
阿托伐他汀组	9.78±1.33	6.42±1.21	4.968	0.001	8.70±0.94	6.21±0.65	3.569	0.002	16.72±1.68	13.04±1.21	3.392	0.004	7.24±0.78	3.75±0.27	3.973	0.001
t值	0.336	0.406	?	?	0.553	0.662	?	?	0.316	0.418	?	?	0.442	0.283	?	?
P值	0.625	0.572	?	?	0.487	0.339	?	?	0.606	0.551	?	?	0.520	0.692	?	?

组别	TC				TG				LDL-C				HDL-C
组别	治疗前	治疗后	t值	P值	治疗前	治疗后	t值	P值	治疗前	治疗后	t值	P值	治疗前	治疗后	t值	P值
对照组	4.83±0.45	4.76±0.39	1.402	0.341	2.25±0.28	2.13±0.31	1.452	0.283	3.22±0.41	3.08±0.39	1.584	0.343	1.01±0.19	1.04±0.15	0.534	0.692
阿托伐他汀组	4.86±0.52	3.18±0.33	3.183	0.007	2.34±0.21	1.69±0.14	3.174	0.002	3.30±0.44	1.74±0.27	4.223	0.001	1.02±0.16	1.26±0.21	2.397	0.021
t值	0.523	2.738	?	?	0.421	3.012	?	?	0.048	3.974	?	?	0.387	2.458	?	?
P值	0.482	0.009	?	?	0.836	0.003	?	?	0.923	0.001	?	?	0.873	0.014	?	?

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