The Effects of Atorvastatin on Arterial Stiffness in Male Patients with Type 2 Diabetes

Abstract

Statin therapy improves lipid profiles and reduces vascular inflammation, but its effects on central arterial stiffness in type 2 diabetes are unclear. The aim of this study was to determine whether statin therapy reduces central arterial stiffness, in a dose-dependent manner, in male patients with type 2 diabetes. Fifty-one patients ceased statin therapy for 6 weeks, followed by randomisation to either 10 or 80 mg of atorvastatin. At randomization, 3 and 12 months, central arterial stiffness was measured via carotid-femoral pulse wave velocity (PWV), along with serum markers of vascular inflammation including high-sensitivity c-reactive protein (hsCRP) and osteoprotegerin (OPG). PWV decreased from 10.37 ± 1.30 to 9.68 ± 1.19 m/sec (p < 0.01 from baseline) at 3 months and 9.10 ± 1.17 m/sec (p < 0.001 from baseline) at 12 months. hsCRP and OPG decreased significantly at 3 and 12 months. Reductions in PWV did not differ significantly between the groups. Baseline PWV and OPG values correlated strongly (r = 0.48, p < 0.01), as did their response to atorvastatin over 12 months (r = 0.36 delta-OPG and delta-PWV, p < 0.01). Atorvastatin therapy appeared to reduce central arterial stiffness in male type 2 diabetes, with no dose-dependent effect observed. The correlation observed between reductions in PWV and OPG suggests that atorvastatin reduces PWV via direct anti-inflammatory effects on the vasculature.

Serum osteoprotegerin level is positively associated with peripheral artery disease in patients with peritoneal dialysis

“…In DM patients, insulin was found to regulate the OPG production and vascular calcification in human aortic smooth muscle cells [29], and 24-week treatment of pioglitazone, which was a agonist of peroxisome proliferator-activated receptor gamma, could down-regulate serum levels of OPG as well as CRP [30]. In addition, treating patients with DM or CAD with atorvastatin or simvastatin appeared to lower serum OPG and high-sensitivity CRP as well as reduce arterial stiffness, which indicated beneficial effects of statin on vasculature through anti-inflammation [31,32]. Although studies had shown medications could have modulatory effects on vessels, there were no significant differences of medications between the normal or low ABI groups in this study.…”

Arterial Stiffness: Pathophysiological and Genetic Aspects

“…Some studies have identified positive results using antihypertensives 67,68 and hypolipidemic agents. 69,70 The effect of antihypertensives, however, is due to the reduction of blood pressure. Thus, pharmacological treatment for other diseases, associated with the measures mentioned above, which may attenuate the loss of elastic fibers in the arteries, may have an additional effect on the control of arterial stiffness.…”

Treatment with high dose of atorvastatin reduces vascular injury in diabetic rats

“…In addition, some authors report that atorvastatin reduces arterial stiffness [51,52], which may occur for its anti-inflammatory actions as COX-2 and oxidative stress reduction, thus contributing to reducing vascular dysfunction.…”