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document
Cholesterol-lowering therapy may retard the progression of diabetic nephropathy . There is experimental evidence to suggest that hypercholesterolaemia may play a pathogenetic role in progressive glomerular injury . We investigated the effect of cholesterol-lowering therapy on the progression of diabetic nephropathy in 34 patients with non-insulin-dependent diabetes mellitus . Patients were randomly assigned in a single-blind fashion to treatment with either lovastatin , an HMG CoA reductase inhibitor ( n = 16 ; mean dose 30.0 +/- 12.6 mg/day ) or placebo ( n = 18 ) for 2 years . Renal function was assessed by serially measuring the serum creatinine , glomerular filtration rate ( using Cr51-EDTA ) , and 24-h urinary protein excretion . Lovastatin treatment was associated with significant reductions in total cholesterol ( p < 0.001 ) , LDL-cholesterol ( p < 0.001 ) and apo B ( p < 0.01 ) , the reductions at 24 months being 26 , 30 and 18 % , respectively . Beneficial effects on serum triglyceride , HDL-cholesterol and apo A1 levels were also observed . Lp ( a ) showed no significant change in both groups . Glomerular filtration rate deteriorated significantly in the placebo group after 24 months ( p < 0.025 ) but showed no significant change in the lovastatin-treated patients . The increase in serum creatinine was statistically significant ( p < 0.02 ) in placebo-treated patients at 12 and 24 months , and in the lovastatin group after 24 months . Twenty-four hour urinary protein excretion increased in both groups ( p < 0.05 ) . Lovastatin treatment was not associated with significant elevations in liver or muscle enzymes . We conclude that effective normalisation of hypercholesterolaemia may retard the progression of diabetic nephropathy .
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Intervention_Physical
Cholesterol-lowering therapy
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Intervention_Pharmacological
lovastatin , an HMG CoA reductase inhibitor
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Intervention_Control
placebo
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Outcome_Physical
total cholesterol
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Outcome_Physical
LDL-cholesterol
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Outcome_Physical
apo B
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Outcome_Physical
serum triglyceride
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Outcome_Physical
HDL-cholesterol
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Outcome_Physical
apo A1 levels
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Outcome_Physical
Lp ( a )
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Outcome_Other
no significant
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Outcome_Other
Glomerular filtration rate deteriorated significantly
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Outcome_Other
no significant change
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Outcome_Physical
increase in serum creatinine
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Outcome_Other
statistically significant
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Outcome_Physical
urinary protein excretion increased
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Outcome_Other
not associated
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Outcome_Physical
significant elevations
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Outcome_Physical
liver or muscle enzymes
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Outcome_Physical
hypercholesterolaemia
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Outcome_Physical
diabetic nephropathy
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Participant_Condition
diabetic nephropathy .
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Participant_Condition
progressive glomerular injury .
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Participant_Sample-size
34
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Participant_Condition
non-insulin-dependent diabetes mellitus