Effect of atorvastatin and metformin combination therapy in type 2 diabetic dyslipidemias
Keywords:Dyslipidemias, Type-2 diabetes mellitus, Atorvastatin, Metformin, Lipid profile, Fasting blood glucose
Background: Dyslipidaemia is a major risk factor for cardiovascular complications in patients with type 2 diabetes mellitus and affects 10-73% of this population. In type 2 diabetes mellitus, increased efflux of free fatty acids from adipose tissue and impaired insulin mediated skeletal muscle uptake of free fatty acids, increases fatty acid flux to the liver and also decreased glucose utilization in muscle that leads to acute elevation of free fatty acids. Lipid profile which is altered in diabetes state is one of the significant factors in development of cardiovascular diseases. The derangements seen in serum lipid profile includes: increased total cholesterol (TC), triglycerides (TG) and low-density lipoprotein (LDL) and decreased high-density lipoprotein cholesterol (HDL) concentration. Hence with the aforementioned views the present study had been planned to evaluate the effect of atorvastatin and metformin combination therapy in type 2 diabetic dyslipidemias.
Methods: Study design, observational prospective study, with duration of 4-5 months and sample size of 30 patients with type 2 diabetes mellitus are taken with mild to moderate dyslipidemias. The study subjects received combination therapy of metformin 500 mg/day along with atorvastatin 20mg/day, there effect is seen on serum lipid profile and fasting blood glucose levels (FBS).
Results: There was a significant mean decrease in TC, LDL , TG , FBS by 31.7 mg/dl (p<0.05), 28.5 mg/dl (p value <0.05), 19.5 mg/dl (p<0.05), 9.13 mg/dl (p<0.05) respectively and rise in HDL by 1.7 mg/dl (p<0.05) ), no significant decrease in VLDL (p>0.05).
Conclusions: Combination of atorvastatin and metformin was effective in reduction of TC, LDL, TG and FBS and elevation of HDL levels in type-2 diabetic dyslipidemias.
Kathore VR, Bansode DG. The effect of vitamin C on fasting blood glucose level and lipid profile in type-2 diabetes mellitus patients. Int J Recent Trends Science Technology. 2015;16(3):585-90.
Sarwar N, Gao P, Seshasai SR. Diabetes mellitus, fasting blood glucose concentration, and risk of vascular disease: a collaborative meta-analysis of 102 prospective studies. Emerging Risk Factors Collaboration. 2010;26(375):2215-22.
DeFronzo RA, Ferrannini E. Insulin resistance: a multifaceted syndrome responsible for NIDDM, obesity, hypertension, dyslipidemia, and atherosclerotic cardiovascular disease. Diabetes Care. 1991;14(3):173-94.
Mithal A, Majhi D, Shunmugavelu M. Prevalence of dyslipidemia in adult Indian diabetic patients: a cross sectional study (SOLID). Indian J Endocrinol Metab. 2014;18(5):642-7.
Boden G. Role of fatty acids in the pathogenesis of insulin resistance and NIDDM. Diabetes. 1997;46:3-10.
Kelley DE, Simoneau JA. Impaired free fatty acid utilization by skeletal muscle in non-insulin-dependent diabetes mellitus. J Clin Invest. 1994;94:2349-56.
Management of Dyslipidemia in Adults with Diabetes American Diabetes Association Diabetes Care. 2003;26:83-6.
Vaughan CJ, Gotto AM, Basson CT. The evolving role of statins in the management of atherosclerosis. J Am Coll Cardiol. 2000;35:1-10.
Kim BH, Han S, Lee H, Park CH, Chung YM, Shin K, et al. Metformin enhances the anti-adipogenic effects of atorvastatin via modulation of STAT3 and TGF-β/Smad3 signaling. Biochemical Biophysical Res Communications. 2015;456(1):173-8.
Balasubramanian R, Varadharajan S, Kathale A, Nagraj LM, Periyandavar I, Nayak UP, et al. Assessment of the efficacy and tolerability of a fixed dose combination of atorvastatin 10 mg and metformin SR 500 mg in diabetic dyslipidaemia in adult Indian patients. Journal Indian Med Association. 2008;106(7):464-7.