Plasma apolipoprotein M responses to statin and fibrate administration in type 2 diabetes mellitus.
OBJECTIVE
Plasma apolipoprotein M (apoM) is potentially anti-atherogenic, and has been found to be associated positively with plasma total, LDL and HDL cholesterol in humans. ApoM may, therefore, be intricately related to cholesterol metabolism. Here, we determined whether plasma apoM is affected by statin or fibrate administration in patients with diabetes mellitus.


METHODS
Fourteen type 2 diabetic patients participated in a placebo-controlled crossover study which included three 8-week treatment periods with simvastatin (40 mg daily), bezafibrate (400 mg daily), and their combination.


RESULTS
ApoM was decreased by 7% in response to simvastatin (P<0.05 from baseline and placebo), and remained unchanged during bezafibrate and combined simvastatin+bezafibrate administration. Plasma apoM concentrations correlated positively with apoB-containing lipoprotein measures at baseline and during placebo (P<0.02 to P<0.001), but these relationships were lost during all lipid lowering treatment periods.


CONCLUSIONS
This study suggests that, even though plasma apoM is lowered by statins, apoM metabolism is to a considerable extent independent of statin- and fibrate-affected pathways involved in cholesterol homeostasis.
Kappelle
Paul J W H
PJ
Department of Endocrinology, University Medical Center Groningen and University of Groningen, Groningen, The Netherlands.
Ahnström
Josefin
J
Dikkeschei
Bert D
BD
de Vries
Rindert
R
Sluiter
Wim J
WJ
Wolffenbuttel
Bruce H R
BH
van Tol
Arie
A
Nielsen
Lars Bo
LB
Dahlbäck
Björn
B
Dullaart
Robin P F
RP
D001053:Apolipoproteins / Q000097:blood*; D000075243:Apolipoproteins M; D001629:Bezafibrate / Q000627:therapeutic use; D001794:Blood Pressure; D002784:Cholesterol / Q000378:metabolism; D018592:Cross-Over Studies; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000188:drug therapy* / Q000276:immunology*; D004311:Double-Blind Method; D058607:Fibric Acids / Q000627:therapeutic use*; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000378:metabolism*; D000960:Hypolipidemic Agents / Q000627:therapeutic use; D054834:Lipocalins; D008297:Male; D008875:Middle Aged; D010919:Placebos; D019821:Simvastatin / Q000627:therapeutic use
C400523:APOM protein, human; D001053:Apolipoproteins; D000075243:Apolipoproteins M; D058607:Fibric Acids; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D000960:Hypolipidemic Agents; D054834:Lipocalins; D010919:Placebos; D002784:Cholesterol; D019821:Simvastatin; D001629:Bezafibrate