title: Improved preservation of residual beta cell function by atorvastatin in patients with recent onset type 1 diabetes and high CRP levels (DIATOR trial).
abstract: BACKGROUND
  A recent randomized placebo-controlled trial of the effect of atorvastatin treatment on the progression of newly diagnosed type 1 diabetes suggested a slower decline of residual beta cell function with statin treatment. Aim of this secondary analysis was to identify patient subgroups which differ in the decline of beta cell function during treatment with atorvastatin.
  
  
  RESULTS
  The randomized placebo-controlled Diabetes and Atorvastatin (DIATOR) Trial included 89 patients with newly diagnosed type 1 diabetes and detectable islet autoantibodies (mean age 30 years, 40% females), in 12 centers in Germany. Patients received placebo or 80 mg/d atorvastatin for 18 months. As primary outcome stimulated serum C-peptide levels were determined 90 min after a standardized liquid mixed meal. For this secondary analysis patients were stratified by single baseline characteristics which were considered to possibly be modified by atorvastatin treatment. Subgroups defined by age, sex or by baseline metabolic parameters like body mass index (BMI), total serum cholesterol or fasting C-peptide did not differ in C-peptide outcome after atorvastatin treatment. However, the subgroup defined by high (above median) baseline C-reactive protein (CRP) concentrations exhibited higher stimulated C-peptide secretion after statin treatment (p = 0.044). Individual baseline CRP levels correlated with C-peptide outcome in the statin group (r(2) = 0.3079, p<0.004). The subgroup with baseline CRP concentrations above median differed from the corresponding subgroup with lower CRP levels by higher median values of BMI, IL-6, IL-1RA, sICAM-1 and E-selectin.
  
  
  CONCLUSIONS
  Atorvastatin treatment may be effective in slowing the decline of beta cell function in a patient subgroup defined by above median levels of CRP and other inflammation associated immune mediators.
  
  
  BACKGROUND
  ClinicalTrials.gov NCT00974740.
authors.affiliation: Institute for Clinical Diabetology, Leibniz Center for Diabetes Research at Heinrich Heine University, Düsseldorf, Germany. alexander.strom@ddz.uni-duesseldorf.de
authors.forename: Alexander
authors.initials: A
authors.lastname: Strom
authors.forename: Hubert
authors.initials: H
authors.lastname: Kolb
authors.forename: Stephan
authors.initials: S
authors.lastname: Martin
authors.forename: Christian
authors.initials: C
authors.lastname: Herder
authors.forename: Marie-Christine
authors.initials: MC
authors.lastname: Simon
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Koenig
authors.forename: Tim
authors.initials: T
authors.lastname: Heise
authors.forename: Lutz
authors.initials: L
authors.lastname: Heinemann
authors.forename: Michael
authors.initials: M
authors.lastname: Roden
authors.forename: Nanette C
authors.initials: NC
authors.lastname: Schloot
mesh_terms: D000293:Adolescent; D000328:Adult; D017668:Age of Onset; D000069059:Atorvastatin; D002096:C-Peptide / Q000097:blood; D002097:C-Reactive Protein / Q000378:metabolism*; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000188:drug therapy*; D005260:Female; D005858:Germany; D006538:Heptanoic Acids / Q000627:therapeutic use*; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D007328:Insulin / Q000097:blood; D050417:Insulin-Secreting Cells / Q000166:cytology / Q000187:drug effects* / Q000378:metabolism*; D008297:Male; D011758:Pyrroles / Q000627:therapeutic use*; D055815:Young Adult
chemical_list: D002096:C-Peptide; D006538:Heptanoic Acids; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D007328:Insulin; D011758:Pyrroles; D002097:C-Reactive Protein; D000069059:Atorvastatin