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Concomitant reduction of low-density lipoprotein-cholesterol and biomarkers of inflammation with low-dose simvastatin therapy in patients with type 1 diabetes.

Hormonal and nutritional effects on cardiovascular risk markers in young women.

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Concomitant reduction of low-density lipoprotein-cholesterol and biomarkers of inflammation with low-dose simvastatin therapy in patients with type 1 diabetes.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Miguelino, Eric Jialal, Ishwarlal Devaraj, Sridevi Griffen, Steven C.
Description	Country affiliation: United States Author Affiliation: Jialal I ( Laboratory for Atherosclerosis and Metabolic Research, University of California, Davis, Medical Center, Sacramento, California 95817, USA. ishwarlal.jialal@ucdmc.ucdavis.edu)
Abstract	CONTEXT: Cardiovascular disease is a major cause of mortality in type 1 diabetes (TIDM). TIDM is a proinflammatory state. Whereas there is consensus on lipid management in type 2 diabetes, there is a lack of data in type 1 diabetes. In addition to benefits on the lipid profile, statin therapy is antiinflammatory. OBJECTIVE: There are scant data on statin therapy in T1DM. Thus, we tested the effect of simvastatin, compared with placebo, on biomarkers of inflammation and monocyte function in TIDM patients. DESIGN: This was a double-blind, randomized, placebo-controlled study of T1DM patients, randomized to placebo or simvastatin, 20 mg/d for 3 months. SETTING: The study was conducted at the University of California, Davis, Medical Center. PARTICIPANTS: Participants included patients with T1DM. METHODS AND RESULTS: Analytes measured at baseline and 3 months included liver function tests, creatinine, hemoglobin AIC, high-sensitivity C-reactive protein, soluble CD40 ligand, monocyte O(2)(-), cytokines, nuclear factor-kappaB. Simvastatin therapy resulted in significant reduction in low-density lipoprotein and non-high-density lipoprotein cholesterol, high-sensitivity C-reactive protein (18% reduction, P < 0.001) and soluble CD40 ligand (22% reduction, P < 0.05), compared with placebo. Simvastatin therapy significantly inhibited lipopolysaccharide-activated monocyte release of O(2)(-) (P < 0.0005), IL-8 (P < 0.03), and TNF (P < 0.02). Simvastatin therapy significantly inhibited monocyte IL-6 release, compared with baseline (P = 0.02). Simvastatin therapy also significantly reduced monocytic nuclear factor-kappaB p65 activity, compared with placebo (P < 0.01). CONCLUSIONS: This study demonstrates that simvastatin (20 mg/d) is safe in T1DM patients and has concomitant benefits on the lipid profile and biomarkers of inflammation. These novel findings could have implications for developing policy guidelines for statin therapy in forestalling vascular complications in young T1DM.
ISSN	0021972X
e-ISSN	19457197
Journal	The Journal of Clinical Endocrinology & Metabolism
Issue Number	8
Volume Number	92
Language	English
Publisher	Oxford University Press
Publisher Date	2007-08-01
Publisher Place	United States
Access Restriction	Open
Subject Keyword	Cholesterol, Ldl Blood Diabetes Mellitus, Type 1 Hydroxymethylglutaryl-coa Reductase Inhibitors Therapeutic Use Inflammation Metabolism Lipoproteins, Ldl Simvastatin Biological Markers Cholesterol Cytokines Double-blind Method Hemoglobin A, Glycosylated Monocytes Drug Effects Physiology Triglycerides Randomized Controlled Trial Research Support, N.i.h., Extramural Discipline Endocrinology Discipline Metabolism
Content Type	Text
Resource Type	Article
Subject	Biochemistry (medical) Endocrinology, Diabetes and Metabolism Clinical Biochemistry Biochemistry Endocrinology

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