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Exp Clin Endocrinol Diabetes 2004; 112(5): 269-277
DOI: 10.1055/s-2004-817975
Article

J. A. Barth Verlag in Georg Thieme Verlag KG Stuttgart · New York

Inhibition of HMG-CoA Reductase with Cerivastatin Lowers Dense Low Density Lipoproteins in Patients with Elevated Fasting Glucose, Impaired Glucose Tolerance and Type 2 Diabetes Mellitus

H. Scharnagl1 , K. Winkler2 , S. Mantz2 , M. W. Baumstark3 , H. Wieland2 , W. März1
  • 1Clinical Institute of Medical and Chemical Laboratory Diagnostics, Karl-Franzens-University, Graz, Austria
  • 2Division of Clinical Chemistry, Department of Medicine, Albert-Ludwigs-University, Freiburg, Germany
  • 3Division of Prevention, Rehabilitation, and Sports Medicine, Department of Medicine, Albert-Ludwigs-University, Freiburg, Germany
Further Information

Publication History

Received: May 7, 2003 First decision: August 18, 2003

Accepted: October 30, 2003

Publication Date:
14 May 2004 (online)

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Abstract

Objective: While 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors effectively decrease LDL cholesterol, it remains controversial whether these agents also lower dense LDL, which are considered particularly atherogenic.

Methods: We examined the effects of the 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitor cerivastatin on lipids, lipoproteins, and apolipoproteins in 69 patients with elevated fasting glucose, impaired glucose tolerance, or type 2 diabetes, combined hyperlipoproteinemia and increased concentrations of dense LDL (apo B in LDL-5 plus LDL-6 > 25 mg/dl). The study was a multicenter, double-blind, randomized, parallel-group comparison of cerivastatin at 0.4 mg daily for 12 weeks (n = 34) and placebo (n = 35).

Results: Cerivastatin significantly reduced cholesterol (- 20 %, p < 0.001), IDL cholesterol - 37 %, p < 0.001), LDL cholesterol (- 26 %, p < 0.001), apolipoprotein B (- 25 %, p < 0.001), triglycerides (- 12 %, p < 0.05), and raised HDL cholesterol (+ 7.5 %, p < 0.05) and apolipoprotein AI (+ 7.2 %, p < 0.05). Cerivastatin signficantly lowered apolipoprotein B in all LDL subfractions (- 21 to - 28 %, p < 0.05). Absolute changes were greatest in dense LDL and the change in dense LDL made the largest contribution to the change of total LDL. The change of dense LDL was highly correlated with baseline values. There was no consistent relationship between the effect of cerivastatin on triglycerides and the decrease of dense LDL.

Conclusions: The HMG CoA reductase inhibitor cerivastatin lowers total and LDL cholesterol and the concentration of dense LDL in patients with elevated fasting glucose, impaired glucose tolerance or type 2 diabetes.

Key words

Coronary heart disease - type 2 diabetes mellitus - impaired glucose tolerance - atherogenic lipoprotein phenotype - HMG-CoA reductase inhibitors

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Hubert Scharnagl

Clinical Institute of Medical and Chemical Laboratory Diagnostics
Karl-Franzens-University Graz

Auenbruggerplatz 15

8036 Graz

Austria

Phone: + 433163857816

Fax: + 43 31 63 85 34 30

Email: hubert.scharnagl@klinikum-graz.at

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