title: Lifestyle intervention and/or statins for the reduction of C-reactive protein in type 2 diabetes: from the look AHEAD study.
abstract: OBJECTIVE
  Cardiovascular risk remains high despite statin use. Overweight/obese diabetic persons usually have normal/low LDL-cholesterol but high C-reactive protein (CRP) levels. We aimed to examine the effects of intensive lifestyle intervention for weight loss (ILI) on CRP levels in overweight/obese diabetic individuals by statin use.
  
  
  METHODS
  Look AHEAD was a randomized trial in overweight/obese type 2 diabetic individuals testing whether ILI would reduce cardiovascular mortality, when compared to usual care. CRP changes in 1,431 participants with biomarker levels, who remained on or off statin treatment for 1 year, were evaluated.
  
  
  RESULTS
  The reduction in CRP levels with ILI at 1 year in men and women on statins was -44.9 and -42.3%, respectively, compared to -13.7 and -21.0% for those on statins and usual care (P < 0.0001). At 1 year, median CRP levels were: 1.8 mg L(-1) in participants randomized to ILI on statin therapy; 2.6 mg L(-1) for those on statins randomized to usual care and 2.9 mg L(-1) for participants not on statins but randomized to ILI. Weight loss was associated with 1-year CRP reduction (P < 0.0001) in statin and nonstatin users.
  
  
  CONCLUSIONS
  Our findings suggest that in overweight/obese diabetic persons, ILI and statin therapy may have substantial additive anti-inflammatory benefits.
authors.affiliation: Department of Medicine, University of Texas Medical Branch, Galveston, Texas, USA. lmbelalc@utmb.edu
authors.forename: L Maria
authors.initials: LM
authors.lastname: Belalcazar
authors.forename: Steven M
authors.initials: SM
authors.lastname: Haffner
authors.forename: Wei
authors.initials: W
authors.lastname: Lang
authors.forename: Ron C
authors.initials: RC
authors.lastname: Hoogeveen
authors.forename: Julia
authors.initials: J
authors.lastname: Rushing
authors.forename: Dawn C
authors.initials: DC
authors.lastname: Schwenke
authors.forename: Russell P
authors.initials: RP
authors.lastname: Tracy
authors.forename: F Xavier
authors.initials: FX
authors.lastname: Pi-Sunyer
authors.forename: Andrea M
authors.initials: AM
authors.lastname: Kriska
authors.forename: Christie M
authors.initials: CM
authors.lastname: Ballantyne
mesh_terms: D000368:Aged; D002097:C-Reactive Protein / Q000378:metabolism*; D002318:Cardiovascular Diseases / Q000097:blood / Q000209:etiology / Q000517:prevention & control; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000150:complications / Q000188:drug therapy / Q000628:therapy*; D004032:Diet; D015444:Exercise; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000494:pharmacology / Q000627:therapeutic use*; D007249:Inflammation / Q000188:drug therapy / Q000209:etiology / Q000628:therapy*; D008019:Life Style; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000097:blood / Q000150:complications / Q000628:therapy*; D015431:Weight Loss / Q000502:physiology*; D061217:Weight Reduction Programs
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D002097:C-Reactive Protein