Anti-inflammatory and anticoagulant effects of pravastatin in patients with type 2 diabetes.
OBJECTIVE
Type 2 diabetes is associated with increased plasma concentrations of coagulation and inflammation markers. Different studies have shown that treatment with hydroxymethylglutaryl-CoA reductase inhibitors (statins) is associated with antithrombotic and anti-inflammatory effects in addition to a cholesterol-lowering effect. Our objective was to evaluate the effect of pravastatin (40 mg/day) on coagulation and inflammation markers in type 2 diabetic patients.


METHODS
This was an open, randomized, crossover study designed with an 8-week intervention period. The study group was comprised of 50 patients with type 2 diabetes (median HbA(1c) 7.1%) and serum total cholesterol of 5-10 mmol/l. We evaluated plasma levels of fibrinogen, F1 + 2, D-dimer, soluble tissue factor (sTF), von Willebrand Factor antigen (vWFag), and C-reactive protein (CRP) in blood samples drawn after fasting on day 1 and after 8 and 16 weeks.


RESULTS
Significant reductions of total cholesterol (-22%; P < 0.001), LDL cholesterol (-32%; P < 0.001), and triglycerides (-10%; P < 0.05) were achieved after 8 weeks of treatment with pravastatin. In addition, significant reductions of plasma levels of F1 + 2 (-4.4%; P < 0.05), vWFag (-5.3%; P < 0.05), and sTF (-3.4%; P < 0.05) were observed after treatment with pravastatin. Furthermore, plasma levels of CRP were also significantly reduced (-13%; P < 0.05). Levels of fibrinogen and D-dimer did not decrease after treatment with pravastatin.


CONCLUSIONS
The results indicated that pravastatin reduces levels of coagulation and inflammation markers in type 2 diabetic patients. These antithrombotic and anti-inflammatory effects of treatment with statins could play a role in reducing cardiovascular complications in type 2 diabetic patients.
Sommeijer
Dirkje W
DW
Laboratory for Experimental Internal Medicine, Academic Medical Center, University of Amsterdam, and Department of Internal Medicine, Slotervaart Hospital, Amsterdam, The Netherlands. d.w.sommeijer@amc.uva.nl
MacGillavry
Melvin R
MR
Meijers
Joost C M
JC
Van Zanten
Anton P
AP
Reitsma
Pieter H
PH
Ten Cate
Hugo
H
D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D000925:Anticoagulants / Q000627:therapeutic use*; D018592:Cross-Over Studies; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000188:drug therapy*; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D008055:Lipids / Q000097:blood; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D017035:Pravastatin / Q000627:therapeutic use*
D000894:Anti-Inflammatory Agents, Non-Steroidal; D000925:Anticoagulants; D006442:Glycated Hemoglobin; D008055:Lipids; D017035:Pravastatin