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Switching fibrate to statin in type 2 diabetic patients: consequences on lipid profile.
Eur J Intern Med. 2009 Mar; 20(2):197-200.EJ

Abstract

Interest of statins in terms of morbid-mortality reduction in primary and secondary prevention in type 2 diabetic patients has broadly been proven in recent studies, while evidence for fibrates preventive effect is considerably weaker. HMGCoA reductase inhibitors are known to decrease low density lipoprotein cholesterol (LDL C) in a greater extension than triglycerides (TG). In type 2 diabetic patients, the dyslipidemic profile is commonly associated with reduced high-density lipoproteins (HDL C), increased TG and normal or mildly elevated LDL C.

PATIENTS AND METHODS

Type 2 diabetic outpatients (n=45) treated with fibrate with or without history of cardiovascular disease were included. Mean age was 57.7+/-13.2 yr, sex ratio was 16/39 (F/M), and BMI was 29.3+/-4.4 kg/m(2). Non-inclusion criteria were TG>or=3.5 g/L and intolerance to statins or a combined lowering lipid therapy. Serum lipid profile, HbA(1c) and creatin kinase (CK) were assessed under treatment with fibrate, then after a 3-month wash-out period, and after a 6-month treatment with a low dose of atorvastatin (10 mg/day).

RESULTS

After a 3-month wash-out period, total cholesterol (TC) was 1.98+/-0.31 g/L (m+/-SD), TG 1.63+/-1.09 g/L, HDL C 0.46+/-0.12 g/L, and LDL C 1.22+/-0.31 g/L. Comparing lipid profile with atorvastatin vs fibrate, we observed a significant decrease in TC and LDL C (1.56 vs 1.79 g/L P=0.001, and 0.84 vs 1.09 g/L, P=0.001, respectively). No significant difference between treatments was observed for TG (1.35 vs 1.17 g/L, P=0.06), and HDL C (0.44 vs 0.48 g/L, P=0.15). When treated with atorvastatin, 90% of patients achieved a LDL C<1 g/L, compared to 51% when treated with fibrate (P=0.001). HbA(1c) remained about 7.6+/-1.5%, and CK in the normal range.

CONCLUSION

In well-controlled type 2 diabetic patients previously treated with fibrate, short-term (6 months) treatment with low-dose atorvastatin (10 mg/day) improves TC and LDL C levels, without any alteration in TG and HDL C levels.

Authors+Show Affiliations

APHP, Department of Internal Medicine, Hôpital Lariboisière, Paris F-75010, France. taly.meas@lrb.aphp.frNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Comparative Study
Journal Article

Language

eng

PubMed ID

19327612

Citation

Meas, T, et al. "Switching Fibrate to Statin in Type 2 Diabetic Patients: Consequences On Lipid Profile." European Journal of Internal Medicine, vol. 20, no. 2, 2009, pp. 197-200.
Meas T, Laloi-Michelin M, Virally M, et al. Switching fibrate to statin in type 2 diabetic patients: consequences on lipid profile. Eur J Intern Med. 2009;20(2):197-200.
Meas, T., Laloi-Michelin, M., Virally, M., Peynet, J., Giraudeaux, V., Kévorkian, J. P., & Guillausseau, P. J. (2009). Switching fibrate to statin in type 2 diabetic patients: consequences on lipid profile. European Journal of Internal Medicine, 20(2), 197-200. https://doi.org/10.1016/j.ejim.2008.06.009
Meas T, et al. Switching Fibrate to Statin in Type 2 Diabetic Patients: Consequences On Lipid Profile. Eur J Intern Med. 2009;20(2):197-200. PubMed PMID: 19327612.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Switching fibrate to statin in type 2 diabetic patients: consequences on lipid profile. AU - Meas,T, AU - Laloi-Michelin,M, AU - Virally,M, AU - Peynet,J, AU - Giraudeaux,V, AU - Kévorkian,J P, AU - Guillausseau,P J, Y1 - 2008/08/15/ PY - 2007/09/25/received PY - 2008/03/19/revised PY - 2008/06/09/accepted PY - 2009/3/31/entrez PY - 2009/3/31/pubmed PY - 2009/6/19/medline SP - 197 EP - 200 JF - European journal of internal medicine JO - Eur. J. Intern. Med. VL - 20 IS - 2 N2 - UNLABELLED: Interest of statins in terms of morbid-mortality reduction in primary and secondary prevention in type 2 diabetic patients has broadly been proven in recent studies, while evidence for fibrates preventive effect is considerably weaker. HMGCoA reductase inhibitors are known to decrease low density lipoprotein cholesterol (LDL C) in a greater extension than triglycerides (TG). In type 2 diabetic patients, the dyslipidemic profile is commonly associated with reduced high-density lipoproteins (HDL C), increased TG and normal or mildly elevated LDL C. PATIENTS AND METHODS: Type 2 diabetic outpatients (n=45) treated with fibrate with or without history of cardiovascular disease were included. Mean age was 57.7+/-13.2 yr, sex ratio was 16/39 (F/M), and BMI was 29.3+/-4.4 kg/m(2). Non-inclusion criteria were TG>or=3.5 g/L and intolerance to statins or a combined lowering lipid therapy. Serum lipid profile, HbA(1c) and creatin kinase (CK) were assessed under treatment with fibrate, then after a 3-month wash-out period, and after a 6-month treatment with a low dose of atorvastatin (10 mg/day). RESULTS: After a 3-month wash-out period, total cholesterol (TC) was 1.98+/-0.31 g/L (m+/-SD), TG 1.63+/-1.09 g/L, HDL C 0.46+/-0.12 g/L, and LDL C 1.22+/-0.31 g/L. Comparing lipid profile with atorvastatin vs fibrate, we observed a significant decrease in TC and LDL C (1.56 vs 1.79 g/L P=0.001, and 0.84 vs 1.09 g/L, P=0.001, respectively). No significant difference between treatments was observed for TG (1.35 vs 1.17 g/L, P=0.06), and HDL C (0.44 vs 0.48 g/L, P=0.15). When treated with atorvastatin, 90% of patients achieved a LDL C<1 g/L, compared to 51% when treated with fibrate (P=0.001). HbA(1c) remained about 7.6+/-1.5%, and CK in the normal range. CONCLUSION: In well-controlled type 2 diabetic patients previously treated with fibrate, short-term (6 months) treatment with low-dose atorvastatin (10 mg/day) improves TC and LDL C levels, without any alteration in TG and HDL C levels. SN - 1879-0828 UR - https://www.unboundmedicine.com/medline/citation/19327612/Switching_fibrate_to_statin_in_type_2_diabetic_patients:_consequences_on_lipid_profile_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0953-6205(08)00193-3 DB - PRIME DP - Unbound Medicine ER -