[Gender difference in hipolipemic and anti-inflammatory effects of statins in diabetics with coronary artery disease].
OBJECTIVE
Statins produce hipolipemic and pleotropic effects on markers of inflammation with stabilization of atheromatous plaque. The aim of this paper was to examine gender difference in hipolipemic and antiinflammatory effects of statins in patients with diabetes mellitus (DM) type 2 with coronary artery disease (CAD).


METHODS
Sixty dyslipidemic patients with DM type 2 were analyzed. Lifestyle modification and hipolipemic diet were applied in all patients divided into two groups: 30 patients with statins therapy (20 mg of simvastatin or equivalent dose of some other statins, during 3 months) and 30 patients without statins therapy. Estimation of obesity, quality of glicoregulation, and determination of inflammatory parameters: C-reactive protein (CRP), fibrinogen, total and differential leukocyte count, intracellular adhesive molecules (ICAM-1), vascular adhesive molecule-(VCAM-1) and lipid profile (total cholesterol--TC, LDL-C, HDL-C, triglicerides--TG) were done.


RESULTS
Women with DM type 2 were more obese and had significant disturbances in lipid profiles, glicoregulation and inflammatory markers compared to men. Statins therapy significantly improved all lipid parameters and quality of glicoregulation in women, while there were only significant reduction of LDL-C and nonHDL-C in males. There were more significant reductions of inflammatory markers in women as compared to men with statins therapy. In the group without statins there was not such significant reduction. Concentration of ICAM-1 was the lowest in men on statins therapy, while there were no significant variability of VCAM-1 values between groups and genders.


CONCLUSIONS
Women with DM type 2 and CAD have more prominent lipoprotein disorders and impaired glicoregulation with expression of enhanced proinflammatory state which could not be seen in men. Statins therapy exerts more favorable effects in women leading to stabilization of lipoprotein profiles, improvement of glicoregulation and reduction of inflammatory markers. More superior antiinflammatory effects of statins therapy in men were registered only in significant ICAM-1 reduction.
Djindjić
Boris
B
Medicinski fakultet Univerziteta u Nisu, Institut za patolosku fiziologiju, Nis, Srbija. boris_dj@medfak.ni.ac.yu
Ranković
Goran
G
Zivić
Misko
M
Savić
Todorka
T
Spasić
Mirjana
M
Bubanj
Maja
M
D000368:Aged; D001786:Blood Glucose / Q000032:analysis; D002097:C-Reactive Protein / Q000032:analysis; D003324:Coronary Artery Disease / Q000097:blood / Q000150:complications / Q000188:drug therapy*; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000150:complications*; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D007249:Inflammation; D018799:Intercellular Adhesion Molecule-1 / Q000097:blood; D008055:Lipids / Q000097:blood*; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications; D012727:Sex Characteristics; D019010:Vascular Cell Adhesion Molecule-1 / Q000097:blood
D001786:Blood Glucose; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D008055:Lipids; D019010:Vascular Cell Adhesion Molecule-1; D018799:Intercellular Adhesion Molecule-1; D002097:C-Reactive Protein