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Long-term effects of simvastatin in hypercholesterolemic patients with NIDDM and additional atherosclerotic risk
1Department of Medicine, Hyogo Medical Center for Adults, Akashi, Japan.
Insights
Simvastatin effectively lowers cholesterol and apoB in patients with type 2 diabetes and hypercholesterolemia. The medication showed neutral effects on glycemic control and was well-tolerated in this patient group.
Area of Science:
- Cardiology
- Endocrinology
- Pharmacology
Background:
- Hypercholesterolemia is a significant risk factor for cardiovascular disease, particularly in patients with non-insulin-dependent diabetes mellitus (NIDDM).
- Effective lipid-lowering strategies are crucial for managing cardiovascular risk in diabetic populations.
Purpose of the Study:
- To evaluate the efficacy and tolerability of simvastatin in patients with NIDDM and hypercholesterolemia.
- To compare the lipid-lowering effects of simvastatin in diabetic versus non-diabetic hypercholesterolemic individuals.
Main Methods:
- A 12-month study involving 48 NIDDM patients and 35 non-diabetic patients with hypercholesterolemia.
- Simvastatin (5-10 mg daily at bedtime) was administered, and effects on lipid profiles, apolipoproteins, and glycemic control were assessed.
Main Results:
- Simvastatin significantly reduced total cholesterol, LDL cholesterol, and apoB in NIDDM patients, with similar reductions observed in non-diabetic patients.
- Triglyceride levels decreased in the NIDDM group, while HDL cholesterol increased in the non-diabetic group but not in the diabetic group.
- Lipid-lowering effects were consistent across various demographic and clinical factors in NIDDM patients, and glycemic control remained unaffected.
Conclusions:
- Simvastatin demonstrates significant benefits in improving lipid profiles and apolipoproteins in hypercholesterolemic NIDDM patients.
- The drug is well-tolerated and does not adversely affect glycemic control, making it a viable option for managing dyslipidemia in this population, even with co-existing risk factors.
Abstract:
Effects of 12 months of simvastatin treatment were examined in 48 NIDDM patients with total serum cholesterol levels exceeding 220 mg/dl and were compared with those in 35 nondiabetic patients with hypercholesterolemia. In the diabetic group, 5-10 mg of simvastatin given once daily at bedtime significantly lowered total cholesterol (21%). LDL cholesterol (28%), apoB (15%) and triglycerides (8%) levels. These changes were identical to those in the nondiabetic group, except for triglycerides which did not change significantly. HDL cholesterol increased significantly in the nondiabetic group but not in the diabetic group. The reductions in LDL cholesterol and apoB in hypercholesterolemic patients with NIDDM were not influenced by gender, age, glycemic control, the presence or absence of systemic hypertension, obesity and overt proteinuria. In addition, the decrease in LDL cholesterol was not affected by the number of risk factors per patient. Simvastatin did not significantly alter hemoglobin A1c or fasting plasma glucose and was well tolerated in both groups. Simvastatin produced beneficial effects on serum lipids and apolipoproteins and neutral effects on glycemic control in hypercholesterolemic patients with NIDDM, whether or not they had an additional atherosclerotic risk factor.