Atorvastatin favorably alters adipokine levels in Type 2 diabetics
MedWire News: Atorvastatin alters levels of novel adipokines, suggesting that a link between adiposity, inflammation, and cardiovascular function may underlie the beneficial effects of statins in diabetic patients, say researchers.
Atorvastatin treatment increases apelin and suppresses visfatin levels in patients with Type 2 diabetes and also lowers carotid intima-media thickness (IMT) if administered in high doses, they say.
As reported in the journal Acta Diabetologica, Nikolas Kadoglou (Hippokratio General Hospital of Thessaloniki, Greece) and team conducted a study of 87 patients without any history of statin treatment, aged 55-70 years, selected from their outpatient diabetes centre.
The team measured carotid IMT in all patients and then assigned them to atorvastatin treatment 10-80mg per day to achieve a target low-density lipoprotein (LDL) cholesterol level of <100 mg/dl.
Blood sampling, ultrasound carotid imaging, and assessment of clinical parameters were performed at baseline and at the end of the study.
The researchers found that atorvastatin increased apelin (from 0.30 pg/ml to 1.54 pg/ml) and decreased visfatin (from 21.54 ng/ml to 15.13 ng/ml) levels in a dose-dependent manner over the 12 months.
Further analysis revealed that the increment in apelin was associated with changes in total cholesterol and LDL cholesterol but not with any alteration in carotid IMT levels.
"This raises questions about the beneficial role which apelin displays in atherosclerosis," say the authors.
On the other hand, the reduction of visfatin was associated with a change in high-sensitivity C-reactive protein (hs-CRP).
"In our study, the atorvastatin-induced hs-CRP decrease was independently associated with the visfatin reduction. Although we cannot rule out additional mechanisms, the anti-inflammatory effect of atorvastatin seems to predominantly explain its effect on visfatin levels," Kadoglou and team write.
Interestingly, the authors also found that while there were no significant changes in either ghrelin levels or mean carotid IMT over the cohort as a whole, they did see a considerable 0.4-mm decrease in carotid IMT in patients treated with high-dose atorvastatin, compared with a 0.1-mm decrease in those receiving the low dose.
In addition, this reduction was found to be significantly related to the visfatin reduction.
"Inconsistent with previous clinical trials, we demonstrated an independent association of visfatin with early atherosclerosis measured by carotid IMT, independent of well-known cardiovascular risk factors," say the authors.
They suggest that the difference could be that previous studies did not examine the interplay between statins and visfatin in the diabetic population.
"Diabetic patients show higher levels of visfatin compared to their nondiabetic counterparts so changes in visfatin's concentrations are therefore more likely to be found," they explain.
MedWire (www.medwire-news.md) is an independent clinical news service provided by Springer Healthcare Limited. © Springer Healthcare Ltd; 2011
By Sally Robertson