DOI: http://dx.doi.org/10.18203/2319-2003.ijbcp20170825

Comparison of the treatment mediated changes in serum lipid profile of cases with metabolic syndrome treated with low dose atorvastatin versus the usual care group

Shubhangam Sharma, Hemlata Verma, Anuradha Dubey

Abstract


Background: Metabolic syndrome (MetS) is a constellation of cardiometabolic risk determinants comprising of obesity, insulin resistance, dyslipidaemia and hypertension. In view of the epidemic of metabolic syndrome, this prospective, comparative study done in OPD setting in a tertiary care centre of central India aimed at finding out the changes in lipid profile, a surrogate marker of cardiovascular morbidities on treatment with low dose atorvastatin versus the usual care group.

Methods: Patients satisfying NCEP-ATPIII criteria for metabolic syndrome were divided into two groups. Group A received treatment with 20 mg Atorvastatin along with target driven treatment for hypertension and elevated glucose, as required. Group B received the same except for atorvastatin. Serum lipid profiles were recorded and changes were compared before and after study duration of 3 months. Also, cardiac events were kept track of during follow up.

Results: At the end of study it was found that treatment mediated changes in the lipid profile were highly significant (p<0.001) and favourable in group A as compared to Group B. Also, lesser cardiovascular outcomes were observed in Group A patients.

Conclusions: The study concludes that among patients with metabolic syndrome, those treated with statins benefitted more than those who did not take statin therapy. This benefit in the correction of serum lipid profile also translated in terms of decreased cardiovascular outcomes in Group A patients. Hence, low dose atorvastatin therapy provides a potential approach for treatment of patients with metabolic syndrome.


Keywords


Atorvastatin, HDL- cholesterol, Lipid profile, LDL- cholesterol, Metabolic syndrome, Triglycerides

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References


Metabolic syndrome (also called insulin resistance syndrome). (National Institutes of Health); Clinical Trials.gov: Medline Plus: Available at: https://medlineplus.gov/metabolicsyndrome.html

Grundy SM. Metabolic Syndrome: A multiplex cardiovascular risk factor, Journal of Clinical Endocrinology and Metabolism. 2007;92(2):399-404.

Eapen D, Kabra GL, Merchant N, Arora A, Khan BV. Metabolic syndrome & cardiovascular disease in South Asian. Vascular Health and Risk Management. 2009;5:731-43.

Misra A, Khurana L. The metabolic syndrome in South Asians: epidemiology, determinants, and prevention, Metabolic syndrome and related disorders. 2009(7);497-514.

Libby P. Prevention and treatment of Atherosclerosis in Kasper Braunwald Fauci eds. Harrison's principles of internal medicine.16th edition. McGraw-Hill Medical; 2005:1430-1433.

McNamara JR, Campos H, Ordovas JM, Peterson J, Wilson PW, Schaefer EJ. Effect of gender, age, and lipid status on low density lipoprotein sub fraction distribution. Results of the Framingham Offspring Study. Arteriosclerosis. 1987;7(5);483-90.

Thomas P. Bersot Drug therapy for Hypercholestremia and Dyslipidemia. In: Laurence Brunton Bruce Chabner Bjorn Knollman eds. Goodman and Gilmans’ - The Pharmacological Basis of Therapeutics 12th Edition, McGraw Hill; 2011:893-894.

Fukuchi S, Hamaguchi K, Seike M, Himeno K, Sakata T, Yoshimatsu H. Role of Fatty Acid Composition in the Development of Metabolic Disorders in Sucrose-Induced Obese Rats. Exp Biol Med. 2004;229(6):486-93.

Diabetes and Metabolism. Metabolic syndrome is becoming increasingly common. It occurs when a range of metabolic risk factors such as obesity and insulin resistance come together. Available at: http://www.diabetes.co.uk/diabetes-and-metabolic-syndrome.html

Larsson B, Svardsudd K, Welin L, Wilhelmsen L, Bjorntorp P, Tibblin G. Abdominal adipose tissue distribution, obesity, and risk of cardiovascular disease and death: 13 year follow up of participants in the study of men born in. Br Med J. 1984;288:1401-04.

Despres JP, Moorjani S, Lupien PJ, Tremblay A, Nadeau A, Bouchard C. Regional distribution of body fat, plasma lipoproteins, and cardiovascular disease. Arteriosclerosis. 1990;10(4):497-511.

Bruce KD, Byrne CD. The metabolic syndrome: common origins of a multifactorial disorder. Postgrad Med J. 2009;85(1009):614-21.

Pedersen TR, Kjekshus J, Berg K, Haghfelt T, Faergeman O, Faergeman G et al. Randomized trial of cholesterol lowering in 4444 patients with coronary heart disease; the Scandinavian Survival Study. Atherosclerosis. 2004;5(3):81-7.

The Long-Term Intervention with Pravastatin in Ischemic Heart Disease (LIPID) Study Group. Prevention of cardiovascular events and death with pravastatin in patients with coronary heart disease and a broad range of initial cholesterol levels. N Eng. J. Med. 1998;339:1349-57.

Lewis SJ, Moye LA, Sacks FM, Johnstone DE, Braunwald E. Effect of Pravastatin on Cardiovascular Events in Older Patients with Myocardial Infarction and Cholesterol Levels in the Average Range: Results of the Cholesterol and Recurrent Events (CARE) Trial N Engl J Med. 1996;335:1001-9.

Athyros VG, Papageorgiou AA, Mercouris BK. Treatment with atorvastatin to the National Cholesterol Education Program versus 'usual' care in secondary -Coronary heart disease prevention. Current Medical Research and Opinion. 2002;18(4):220-28.

Mikhailidis DP, Wierzbicki AS. The Greek Atorvastatin and Coronary-heart-disease Evaluation (Greace) study. Curr. Med. Res Opin. 2002;18(4):215-9.

Atorvastatin comparative cholesterol efficacy and safety study. Department of Health Management and Policy, University of Michigan, Ann Arbor, USA. 2003; 21(1):13-23.

Collins R, Armitage J, Parish S, Sleight P, Peto R. Heart Protection Study Collaborative Group. Effects of cholesterol-lowering with simvastatin on stroke and other major vascular events in 20536 people with cerebrovascular disease or high- risk conditions. Lancet. 2004;363(9411):757-67.

Heart Protection Study Collaborative Group, MRC/BHF Heart Protection Study of cholesterol lowering with simvastatin in 20 536 high-risk individuals; a randomized placebo-controlled trial. 2002;360(9326):7-22.

Deedwania PC, Gupta M, Stein M, Ycas J, Gold A. IRIS Study Group. Comparison of rosuvastatin versus atorvastatin in South-Asian patients at risk of coronary heart disease (from the IRIS Trial) Am J Cardiol. 2007;99:1538-43.