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document
Elevation of HDL-C in response to statin treatment is involved in the regression of carotid atherosclerosis . AIM Atherosclerosis is strongly associated with an increased mortality in subjects with diabetes . The carotid intima-media thickness ( IMT ) is commonly measured as a surrogate marker for cardiovascular risk . Statins are well-established protective agents against atherosclerosis and reportedly suppress IMT progression in subjects with diabetes . To clarify the effects of statins on subclinical atherosclerosis , we herein investigated changes in the carotid IMT and lipid profiles in a multi-center , prospective , randomized trial . METHODS Hypercholesterolemic subjects with type 2 diabetes were randomly assigned to open-label treatment with either pravastatin or pitavastatin . The primary endpoint of this study was the IMT change after 36 months of statin treatment . RESULTS A total of 97 subjects ( 51 pitavastatin ; 46 pravastatin ) completed this 36-month study . The LDL-C decreased significantly from 163.4 ± 27.9 mg/dl at baseline to 100.4 ± 19.6 mg/dl at 36 months in the pitavastatin group and from 159.7 ± 25.6 mg/dl to 118.5 ± 22.1 mg/dl in the pravastatin group . The mean IMT showed moderate regression in both the pitavastatin ( -0.070 ± 0.215 mm , P < 0.05 ) and the pravastatin ( -0.067 ± 0.260 mm ) group . However , there was no significant difference in the IMT change between the two groups . When the two groups were combined , the 36-month change in the mean IMT was significantly associated with HDL-C change ( r=-0.24 , P= 0.03 ) . Multiple linear regression analysis revealed the change in HDL-C to be an independent variable showing a positive correlation with the carotid IMT reduction . CONCLUSION The administration of statins for 3 years to subjects with type 2 diabetes resulted in a significant regression of the carotid IMT . An elevation of the plasma HDL-C with statin treatment was closely related to a regression of atherosclerosis .
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Intervention_Pharmacological
statin
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Intervention_Pharmacological
pravastatin
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Intervention_Pharmacological
pitavastatin
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Intervention_Pharmacological
statin
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Intervention_Pharmacological
pitavastatin
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Intervention_Pharmacological
pravastatin
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Intervention_Pharmacological
pitavastatin
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Intervention_Pharmacological
pravastatin
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Outcome_Physical
carotid intima-media thickness ( IMT )
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Outcome_Physical
IMT change
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Outcome_Physical
LDL-C
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Outcome_Other
The mean
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Outcome_Physical
in the IMT change
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Outcome_Other
the mean
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Outcome_Physical
associated with HDL-C change
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Outcome_Physical
change in
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Outcome_Physical
the carotid
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Outcome_Physical
the plasma
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Participant_Condition
carotid atherosclerosis
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Participant_Condition
diabetes
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Participant_Condition
type 2 diabetes
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Participant_Sample-size
97
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Participant_Sample-size
51
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Participant_Sample-size
46