title: Disparate effects of atorvastatin compared with simvastatin on C-reactive protein concentrations in patients with type 2 diabetes.
abstract: 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.
authors.affiliation: Department of Diabetes, Endocrinology and Metabolism, Hull York Medical School, Hull, U.K. thozhukat.sathyapalan@hyms.ac.uk
authors.forename: Thozhukat
authors.initials: T
authors.lastname: Sathyapalan
authors.forename: Stephen L
authors.initials: SL
authors.lastname: Atkin
authors.forename: Eric S
authors.initials: ES
authors.lastname: Kilpatrick
mesh_terms: 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*
chemical_list: D000924:Anticholesteremic Agents; D006538:Heptanoic Acids; D011758:Pyrroles; D002097:C-Reactive Protein; D000069059:Atorvastatin; D019821:Simvastatin
references.citation: Mayo Clin Proc. 2008 Dec;83(12):1316-25
references.pmid: 19046550
references.citation: Diabet Med. 2008 Aug;25(8):909-15
references.pmid: 18959603
references.citation: BMJ. 2003 Jun 28;326(7404):1423
references.pmid: 12829554
references.citation: Diabetes Care. 2004 Jan;27(1):278-80
references.pmid: 14694008
references.citation: Clin Chem. 2005 Oct;51(10):1905-7
references.pmid: 16189386
references.citation: Crit Rev Clin Lab Sci. 1989;27(5):409-37
references.pmid: 2679660
references.citation: Circulation. 2005 Aug 30;112(9):1289-95
references.pmid: 16116058
references.citation: J Clin Endocrinol Metab. 2003 Apr;88(4):1528-33
references.pmid: 12679434
references.citation: Circulation. 2006 Jul 25;114(4):281-8
references.pmid: 16847150
references.citation: Lancet. 2009 Apr 4;373(9670):1175-82
references.pmid: 19329177
references.citation: JAMA. 2005 Nov 16;294(19):2437-45
references.pmid: 16287954
references.citation: Ann Clin Biochem. 2002 Mar;39(Pt 2):85-8
references.pmid: 11928769
references.citation: N Engl J Med. 2005 Jan 6;352(1):20-8
references.pmid: 15635109
references.citation: Circulation. 1999 Jan 19;99(2):185-8
references.pmid: 9892578
references.citation: J Am Coll Cardiol. 2005 May 17;45(10):1644-8
references.pmid: 15893181