Disparate effects of atorvastatin compared with simvastatin on C-reactive protein concentrations in patients with type 2 diabetes.
OBJECTIVE
Reduction in LDL and high sensitivity (hs) C-reactive protein (CRP) are independent indicators of successful cardiovascular risk reduction with statins. This study compared the effect of equivalent LDL-lowering doses of simvastatin and atorvastatin on hsCRP in type 2 diabetic patients.


METHODS
A crossover study of 26 patients with type 2 diabetes taking either 40 mg simvastatin or 10 mg atorvastatin was undertaken. After 3 months on one statin, lipids and hsCRP were measured on 10 occasions over a 5-week period. The same procedure was then followed taking the other statin.


RESULTS
LDL was comparable on either treatment: atorvastatin 2.2 +/- 0.2 vs. 2.1 +/- 0.3 mmol/l (mean +/- SD; P = 0.19). CRP of individuals taking atorvastatin was significantly lower than when they were taking simvastatin (median 1.08 vs. 1.47 mg/l, P = 0.0002) and was less variable (median SD of logCRP 0.0036 vs. 0.178, P = 0.0001).


CONCLUSIONS
Compared with simvastatin, atorvastatin reduced hsCRP and its variability in type 2 diabetic patients. This enhanced anti-inflammatory effect may prove beneficial if lower CRP is associated with improved cardiovascular risk.
Sathyapalan
Thozhukat
T
Department of Diabetes, Endocrinology and Metabolism, Hull York Medical School, Hull, U.K. thozhukat.sathyapalan@hyms.ac.uk
Atkin
Stephen L
SL
Kilpatrick
Eric S
ES
D000924:Anticholesteremic Agents / Q000627:therapeutic use*; D000069059:Atorvastatin; D002097:C-Reactive Protein / Q000378:metabolism*; D018592:Cross-Over Studies; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy* / Q000378:metabolism*; D006538:Heptanoic Acids / Q000627:therapeutic use*; D006801:Humans; D011758:Pyrroles / Q000627:therapeutic use*; D019821:Simvastatin / Q000627:therapeutic use*
D000924:Anticholesteremic Agents; D006538:Heptanoic Acids; D011758:Pyrroles; D002097:C-Reactive Protein; D000069059:Atorvastatin; D019821:Simvastatin
Mayo Clin Proc. 2008 Dec;83(12):1316-25
19046550
Diabet Med. 2008 Aug;25(8):909-15
18959603
BMJ. 2003 Jun 28;326(7404):1423
12829554
Diabetes Care. 2004 Jan;27(1):278-80
14694008
Clin Chem. 2005 Oct;51(10):1905-7
16189386
Crit Rev Clin Lab Sci. 1989;27(5):409-37
2679660
Circulation. 2005 Aug 30;112(9):1289-95
16116058
J Clin Endocrinol Metab. 2003 Apr;88(4):1528-33
12679434
Circulation. 2006 Jul 25;114(4):281-8
16847150
Lancet. 2009 Apr 4;373(9670):1175-82
19329177
JAMA. 2005 Nov 16;294(19):2437-45
16287954
Ann Clin Biochem. 2002 Mar;39(Pt 2):85-8
11928769
N Engl J Med. 2005 Jan 6;352(1):20-8
15635109
Circulation. 1999 Jan 19;99(2):185-8
9892578
J Am Coll Cardiol. 2005 May 17;45(10):1644-8
15893181