Combined effects of atorvastatin and metformin on glucose-induced variations of inflammatory process in patients with diabetes mellitus.
BACKGROUND
Statin treatment improves survival in patients with atherosclerosis, but their effect on the glucose-induced variations of inflammatory markers, is unknown. We examined the effect of combined therapy with atorvastatin and metformin on glucose-induced variations of inflammatory molecules in patients with newly diagnosed diabetes mellitus type 2 (DM).


METHODS
Thirty five subjects with newly diagnosed DM were randomized to receive metformin 850 mg/d (M, n=17) or metformin 850 mg/d+atorvastatin 10mg (n=18). All subjects underwent glucose loading (75 g oral glucose) at baseline and after 12 weeks of treatment. Blood samples were obtained at baseline and 3h post-loading, while serum tumor necrosis factor alpha (TNF-α) levels were determined at baseline and at 3h.


RESULTS
Serum TNF-α remained unchanged in metformin at baseline (1.36±0.18 to 1.47±0.21 pg/ml p=NS) and after treatment (1.44±0.71 to 1.31±0.17 pg/ml, p=NS), while it was reduced in metformin+atorvastatin (2.3±0.3 to 2.0±0.4 pg/ml, p=NS at baseline and 1.80±0.2 to 1.65±0.2 pg/ml, p=0.03 after treatment).


CONCLUSIONS
Interestingly, the combination of metformin and atorvastatin partly prevents the glucose-loading induced elevation of glucose levels (at 1 h), suggesting a better response to glucose intake than monotherapy with metformin. In addition, combined treatment with atorvastatin and metformin reduces the post-glucose loading levels of TNF-α compared to metformin monotherapy.
Tousoulis
Dimitris
D
1st Cardiology Department, Athens University Medical School, Athens, Greece. tousouli@med.uoa.gr
Koniari
Katerina
K
Antoniades
Charalambos
C
Papageorgiou
Nikolaos
N
Miliou
Antogoni
A
Noutsou
Marina
M
Nikolopoulou
Aggeliki
A
Marinou
Kyriakoula
K
Stefanadi
Elli
E
Siasos
Gerasimos
G
Charakida
Marietta
M
Kamboli
Anna-Maria
AM
Stefanadis
Christodoulos
C
D000328:Adult; D000368:Aged; D000924:Anticholesteremic Agents / Q000008:administration & dosage; D000069059:Atorvastatin; D001786:Blood Glucose / Q000187:drug effects / Q000276:immunology* / Q000378:metabolism; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000188:drug therapy* / Q000276:immunology*; D004359:Drug Therapy, Combination; D005260:Female; D006538:Heptanoic Acids / Q000008:administration & dosage*; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage; D007249:Inflammation / Q000188:drug therapy* / Q000209:etiology / Q000276:immunology; D008297:Male; D008687:Metformin / Q000008:administration & dosage*; D008875:Middle Aged; D011758:Pyrroles / Q000008:administration & dosage*; D016896:Treatment Outcome; D014409:Tumor Necrosis Factor-alpha / Q000097:blood
D000924:Anticholesteremic Agents; D001786:Blood Glucose; D006538:Heptanoic Acids; D007004:Hypoglycemic Agents; D011758:Pyrroles; D014409:Tumor Necrosis Factor-alpha; D008687:Metformin; D000069059:Atorvastatin