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Randomized Trial of Atorvastatin in Improving Endothelial Function in Diabetics without Prior Coronary Disease and Having Average Cholesterol Level
Wirote Tantikosoom, MD*, Bandit Thinkhamrop, PhD**,
Songsak Kiatchusakul, MD***, Narumol Jarernsiripornkul, PhD****,
Jiraporn Srinakarin, MD*****, Siwanit Ojongpian, MD*****
* Queen Sirikit Heart Centre, Khon Kaen University, Khon Kaen
** Department of Biostatistics and Demography, Faculty of Public Health, Khon Kaen University, Khon Kaen
*** Department of Internal Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen
**** Clinical Pharmacy Department, Faculty of Pharmaceutical Sciences, Khon Kaen University, Khon Kaen
***** Department of Radiology, Faculty of Medicine, Khon Kaen University, Khon Kaen
Objective: The aim of this study was to determine whether HMGCoA reductase inhibitor with atorvastatin can modulate endothelial function in type II diabetics having average cholesterol and no prior cardiovascular disease.
Material and Method: Type II diabetics, with no prior cardiovascular events and total cholesterol at admission of < 200 mg/dl or LDL < 140 mg/dl, were randomized to placebo (n = 20) or atorvastatin 20 mg daily (n = 22) for 30 weeks. Brachial artery endothelium-dependent dilatation or flow-mediated dilatation (FMD) and endothelium-independent dilatation or nitroglycerine-mediated dilatation (NTGMD) were measured at baseline and after thirty weeks of treatment.
Results: Baseline clinical characteristics were similar at admission in both groups. After thirty weeks of treatment, the FMD did not significantly change in either the atorvastatin or placebo group (4.11 + 1.05% to 3.01 + 1.27% vs 5.75 + 1.93% to 6.45 + 1.41%, respectively; p = 0.46 by analysis of covariance). Similarly, the NTGM did not change in either group.
Conclusion: The addition of HMGCoA reductase inhibitor with atorvastatin did not improve endothelial function in type 2 diabetes having average cholesterol with no prior cardiovascular disease, despite an improvement of the lipid profile.
Keyword : Type 2 diabetes, Endothelial dysfunction, Atorvastatin
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