Effects of patient-tailored atorvastatin therapy on ameliorating the levels of atherogenic lipids and inflammation beyond lowering low-density lipoprotein cholesterol in patients with type 2 diabetes.
OBJECTIVE
Recently, patient-tailored statin therapy was proven effective for achieving target low-density lipoprotein (LDL) cholesterol levels. It is unclear, however, whether this therapeutic modality would be effective for atherogenic lipid profiles and inflammation in patients with type 2 diabetes.


METHODS
The present study was an 8-week, multicenter, single-step titration trial of patient-tailored atorvastatin therapy (10, 20 and 40 mg) according to baseline LDL cholesterol levels in 440 patients with type 2 diabetes. We measured the LDL particle size by polyacrylamide gel electrophoresis, and used high-sensitivity C-reactive protein (hsCRP) and adiponectin as surrogate markers of inflammation.


RESULTS
In the intention-to-treat analysis, 91% of the patients achieved their LDL cholesterol targets (<2.6 mmol/L) at week 8. There were significant reductions at week 8 in total cholesterol, triglycerides, non-high-density lipoprotein cholesterol (HDL) cholesterol, and the total cholesterol:HDL cholesterol ratio compared with the baseline values for all of the doses. The mean LDL particle size was significantly increased, and the small, dense LDL cholesterol levels were decreased in a dose-dependent manner over the study period. In addition, the hsCRP levels were decreased in those high-risk patients with baseline hsCRP levels over 3 mg/L (P < 0.001), and the adiponectin levels tended to increase with all of the doses (P = 0.004) at 8 weeks.


CONCLUSIONS
Patient-tailored atorvastatin therapy based on LDL cholesterol at baseline was effective in ameliorating atherogenic LDL particle size and inflammation, in addition to achieving the target LDL cholesterol level without an undesirable effect on glycemic control in patients with type 2 diabetes. This trial was registered with ClinicalTrials.gov (no. NCT01239849).
Division of Endocrinology and Metabolism Department of Internal Medicine The Catholic University of Korea Bucheon St. Mary's Hospital Bucheon Korea.
Jang Won
JW
Son
Division of Endocrinology and Metabolism Department of Internal Medicine Inje University Ilsan Paik Hospital Ilsan Korea.
Dong Jun
DJ
Kim
Division of Endocrinology and Metabolism Department of Internal Medicine Hanyang University Guri Hospital Guri Korea.
Chang Beom
CB
Lee
Department of Endocrinology and Metabolism Kyunghee University Medical Center Seoul Korea.
Seungjoon
S
Oh
Division of Endocrinology and Metabolism Department of Internal Medicine Konkuk University School of Medicine Seoul Korea.
Kee-Ho
KH
Song
Division of Endocrinology and Metabolism Department of Internal Medicine Soonchunhyang University Hospital Bucheon Bucheon Korea.
Chan Hee
CH
Jung
Division of Endocrinology and Metabolism Department of Internal Medicine Soonchunhyang University Hospital Bucheon Bucheon Korea.
Ji Oh
JO
Mok
Division of Endocrinology and Metabolism Department of Internal Medicine Sejong General Hospital Bucheon Korea.
Jong Hwa
JH
Kim
Division of Endocrinology and Metabolism Department of Internal Medicine Boramae Medical Center Seoul Korea.
Min Kyong
MK
Moon
Division of Endocrinology and Metabolism Department of Internal Medicine Korea University Guro Hospital Seoul Korea.
Kyung Mook
KM
Choi
Division of Endocrinology and Metabolism Department of Internal Medicine The Catholic University of Korea Seoul St. Mary's Hospital Seoul Korea.
Jae Hyoung
JH
Cho
Division of Endocrinology and Metabolism Department of Internal Medicine Seoul National University Bundang Hospital Seongnam Korea.
Sung Hee
SH
Choi
Division of Endocrinology and Metabolism Department of Internal Medicine Pochon Cha University Bundang Hospital Seongnam Korea.
Soo Kyung
SK
Kim
Division of Endocrinology and Metabolism Department of Internal Medicine Eulji University Hospital Seoul Korea.
Kang Seo
KS
Park
Division of Endocrinology and Metabolism Department of Internal Medicine Keimyung University Dongsan Medical Center Daegu Korea.
Hye Soon
HS
Kim
Division of Endocrinology and Metabolism Department of Internal Medicine Pusan National University Hospital Busan Korea.
In Joo
IJ
Kim
Division of Endocrinology and Metabolism Department of Internal Medicine Ulsan University Hospital Ulsan Korea.
Young Il
YI
Kim
Division of Endocrinology and Metabolism Department of Internal Medicine Ajou University Hospital Suwon Korea.
Hae Jin
HJ
Kim
Division of Endocrinology and Metabolism Department of Internal Medicine Chosun University Hospital Gwangju Korea.
Sang Yong
SY
Kim
Division of Endocrinology and Metabolism Department of Internal Medicine The Catholic University of Korea Bucheon St. Mary's Hospital Bucheon Korea.
Sungrae
S
Kim
Atorvastatin; Low‐density lipoprotein cholesterol; Type 2 diabetes mellitus