Anti-Inflammatory and Anticoagulant Effects of Pravastatin in Patients With Type 2 Diabetes
- Dirkje W. Sommeijer, MD12,
- Melvin R. MacGillavry, MD, PHD2,
- Joost C.M. Meijers, PHD3,
- Anton P. Van Zanten, PHD4,
- Pieter H. Reitsma, PHD1 and
- Hugo Ten Cate, MD, PHD125
- 1Laboratory for Experimental Internal Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands
- 2Department of Internal Medicine, Slotervaart Hospital, Amsterdam, the Netherlands
- 3Department of Vascular Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands
- 4Department of Clinical Chemistry, Slotervaart Hospital, Amsterdam, the Netherlands
- 5Department of Internal Medicine and Cardiovascular Research Institute Maastricht, Academic Hospital and University of Maastricht, Maastricht, the Netherlands
- Address correspondence and reprint requests to Dirkje W. Sommeijer, MD, Laboratory of Experimental and Internal Medicine, G2–108, Meibergdreef 9, 1105 AZ Amsterdam, Netherlands. E-mail: d.w.sommeijer{at}amc.uva.nl
Abstract
OBJECTIVE—Type 2 diabetes is associated with increased plasma concentrations of coagulation and inflammation markers. Different studies have shown that treatment with hydroxymethylglutaryl-CoA reductase inhibitors (statins) is associated with antithrombotic and anti-inflammatory effects in addition to a cholesterol-lowering effect. Our objective was to evaluate the effect of pravastatin (40 mg/day) on coagulation and inflammation markers in type 2 diabetic patients.
RESEARCH DESIGN AND METHODS—This was an open, randomized, crossover study designed with an 8-week intervention period. The study group was comprised of 50 patients with type 2 diabetes (median HbA1c 7.1%) and serum total cholesterol of 5–10 mmol/l. We evaluated plasma levels of fibrinogen, F1 + 2, d-dimer, soluble tissue factor (sTF), von Willebrand Factor antigen (vWFag), and C-reactive protein (CRP) in blood samples drawn after fasting on day 1 and after 8 and 16 weeks.
RESULTS—Significant reductions of total cholesterol (−22%; P < 0.001), LDL cholesterol (−32%; P < 0.001), and triglycerides (−10%; P < 0.05) were achieved after 8 weeks of treatment with pravastatin. In addition, significant reductions of plasma levels of F1 + 2 (−4.4%; P < 0.05), vWFag (−5.3%; P < 0.05), and sTF (−3.4%; P < 0.05) were observed after treatment with pravastatin. Furthermore, plasma levels of CRP were also significantly reduced (−13%; P < 0.05). Levels of fibrinogen and d-dimer did not decrease after treatment with pravastatin.
CONCLUSIONS—The results indicated that pravastatin reduces levels of coagulation and inflammation markers in type 2 diabetic patients. These antithrombotic and anti-inflammatory effects of treatment with statins could play a role in reducing cardiovascular complications in type 2 diabetic patients.
- ALT, alanine aminotransferase
- AST, aspartate aminotransferase
- CK, creatine phosphokinase
- ELISA, enzyme-linked immunosorbent assay
- hs-CRP, high-sensitivity C-reactive protein
- IL, interleukin
- sTF, soluble tissue factor
- TNF-α, tumor necrosis factor-α
- vWFag, von Willebrand factor antigen
Footnotes
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A table elsewhere in this issue shows conventional and Système International (SI) units and conversion factors for many substances.
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- Accepted October 23, 2003.
- Received January 28, 2003.
- DIABETES CARE
