The effect of atorvastatin on serum lipids, lipoproteins and NMR spectroscopy defined lipoprotein subclasses in type 2 diabetic patients with ischaemic heart disease

CARDS Investigators

Research output: Contribution to journalArticleScientificpeer-review

Abstract

The effect of statin therapy on subclasses of LDL, VLDL and HDL lipoproteins is unclear. We compared changes in serum lipids, apolipoproteins and nuclear magnetic resonance (NMR) spectroscopy measured lipoprotein subclass concentration and average particle size over a minimum 6 months treatment period of atorvastatin 10 mg vs. placebo in 122 men and women. All subjects had type 2 diabetes and a modest dyslipidaemia (mean LDL-cholesterol 3.2 mmol/l and median triglycerides 1.8 mmol/l) and had a previous myocardial infarction. Compared with placebo, atorvastatin therapy was associated with a greater decrease in medium VLDL (median within person change -13.4 vs. -5.9 nmol/l, P<0.001 adjusted for baseline level), small VLDL (median change -17.8 vs. -8.1 nmol/l, P=0.002), large LDL (mean within person change -167.9 vs. -48.6 nmol/l, P<0.001) and medium LDL (median within person change -101.8 vs. -22.3 nmol/l, P=0.017). Atorvastatin therapy was also associated with a greater increase in large HDL than placebo (median change 1.40 vs. 0.80 micromol/l, P=0.02) and there was little change in small HDL so that average HDL particle size increased significantly with atorvastatin (P=0.04). In addition to reducing levels of (enzymatically measured) triglyceride, LDL-cholesterol and apolipoprotein B in diabetic patients, atorvastatin significantly reduces NMR measured medium and small VLDL and large and medium LDL, and increases large HDL.

Original languageEnglish
Pages (from-to)243-55
Number of pages13
JournalAtherosclerosis
Volume167
Issue number2
DOIs
Publication statusPublished - Apr 2003
Externally publishedYes

Fingerprint

Lipids
Serum
Placebos
Particle Size
LDL Cholesterol
Hydroxymethylglutaryl-CoA Reductase Inhibitors
Dyslipidemias
Type 2 Diabetes Mellitus
Atorvastatin Calcium
oxidized low density lipoprotein

Keywords

  • Aged
  • Atorvastatin Calcium
  • Diabetes Mellitus, Type 2/complications
  • Double-Blind Method
  • Female
  • Heptanoic Acids/administration & dosage
  • Humans
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors/administration & dosage
  • Hyperlipidemias/complications
  • Lipoproteins, HDL/blood
  • Lipoproteins, LDL/blood
  • Lipoproteins, VLDL/blood
  • Magnetic Resonance Spectroscopy
  • Male
  • Middle Aged
  • Myocardial Ischemia/complications
  • Patient Compliance
  • Probability
  • Pyrroles/administration & dosage
  • Reference Values
  • Risk Assessment
  • Treatment Outcome

Cite this

@article{85b11a31db964c4186548078e42a4457,
title = "The effect of atorvastatin on serum lipids, lipoproteins and NMR spectroscopy defined lipoprotein subclasses in type 2 diabetic patients with ischaemic heart disease",
abstract = "The effect of statin therapy on subclasses of LDL, VLDL and HDL lipoproteins is unclear. We compared changes in serum lipids, apolipoproteins and nuclear magnetic resonance (NMR) spectroscopy measured lipoprotein subclass concentration and average particle size over a minimum 6 months treatment period of atorvastatin 10 mg vs. placebo in 122 men and women. All subjects had type 2 diabetes and a modest dyslipidaemia (mean LDL-cholesterol 3.2 mmol/l and median triglycerides 1.8 mmol/l) and had a previous myocardial infarction. Compared with placebo, atorvastatin therapy was associated with a greater decrease in medium VLDL (median within person change -13.4 vs. -5.9 nmol/l, P<0.001 adjusted for baseline level), small VLDL (median change -17.8 vs. -8.1 nmol/l, P=0.002), large LDL (mean within person change -167.9 vs. -48.6 nmol/l, P<0.001) and medium LDL (median within person change -101.8 vs. -22.3 nmol/l, P=0.017). Atorvastatin therapy was also associated with a greater increase in large HDL than placebo (median change 1.40 vs. 0.80 micromol/l, P=0.02) and there was little change in small HDL so that average HDL particle size increased significantly with atorvastatin (P=0.04). In addition to reducing levels of (enzymatically measured) triglyceride, LDL-cholesterol and apolipoprotein B in diabetic patients, atorvastatin significantly reduces NMR measured medium and small VLDL and large and medium LDL, and increases large HDL.",
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author = "{CARDS Investigators} and S.S. Soedamah-Muthu and Colhoun, {H M} and Thomason, {M J} and Betteridge, {D J} and Durrington, {P N} and Hitman, {G A} and Fuller, {J H} and K Julier and Mackness, {M I} and Neil, {H A W}",
year = "2003",
month = "4",
doi = "10.1016/S0021-9150(02)00428-8",
language = "English",
volume = "167",
pages = "243--55",
journal = "Atherosclerosis",
issn = "0021-9150",
publisher = "Elsevier Ireland Ltd",
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}

The effect of atorvastatin on serum lipids, lipoproteins and NMR spectroscopy defined lipoprotein subclasses in type 2 diabetic patients with ischaemic heart disease. / CARDS Investigators.

In: Atherosclerosis, Vol. 167, No. 2, 04.2003, p. 243-55.

Research output: Contribution to journalArticleScientificpeer-review

TY - JOUR

T1 - The effect of atorvastatin on serum lipids, lipoproteins and NMR spectroscopy defined lipoprotein subclasses in type 2 diabetic patients with ischaemic heart disease

AU - CARDS Investigators

AU - Soedamah-Muthu, S.S.

AU - Colhoun, H M

AU - Thomason, M J

AU - Betteridge, D J

AU - Durrington, P N

AU - Hitman, G A

AU - Fuller, J H

AU - Julier, K

AU - Mackness, M I

AU - Neil, H A W

PY - 2003/4

Y1 - 2003/4

N2 - The effect of statin therapy on subclasses of LDL, VLDL and HDL lipoproteins is unclear. We compared changes in serum lipids, apolipoproteins and nuclear magnetic resonance (NMR) spectroscopy measured lipoprotein subclass concentration and average particle size over a minimum 6 months treatment period of atorvastatin 10 mg vs. placebo in 122 men and women. All subjects had type 2 diabetes and a modest dyslipidaemia (mean LDL-cholesterol 3.2 mmol/l and median triglycerides 1.8 mmol/l) and had a previous myocardial infarction. Compared with placebo, atorvastatin therapy was associated with a greater decrease in medium VLDL (median within person change -13.4 vs. -5.9 nmol/l, P<0.001 adjusted for baseline level), small VLDL (median change -17.8 vs. -8.1 nmol/l, P=0.002), large LDL (mean within person change -167.9 vs. -48.6 nmol/l, P<0.001) and medium LDL (median within person change -101.8 vs. -22.3 nmol/l, P=0.017). Atorvastatin therapy was also associated with a greater increase in large HDL than placebo (median change 1.40 vs. 0.80 micromol/l, P=0.02) and there was little change in small HDL so that average HDL particle size increased significantly with atorvastatin (P=0.04). In addition to reducing levels of (enzymatically measured) triglyceride, LDL-cholesterol and apolipoprotein B in diabetic patients, atorvastatin significantly reduces NMR measured medium and small VLDL and large and medium LDL, and increases large HDL.

AB - The effect of statin therapy on subclasses of LDL, VLDL and HDL lipoproteins is unclear. We compared changes in serum lipids, apolipoproteins and nuclear magnetic resonance (NMR) spectroscopy measured lipoprotein subclass concentration and average particle size over a minimum 6 months treatment period of atorvastatin 10 mg vs. placebo in 122 men and women. All subjects had type 2 diabetes and a modest dyslipidaemia (mean LDL-cholesterol 3.2 mmol/l and median triglycerides 1.8 mmol/l) and had a previous myocardial infarction. Compared with placebo, atorvastatin therapy was associated with a greater decrease in medium VLDL (median within person change -13.4 vs. -5.9 nmol/l, P<0.001 adjusted for baseline level), small VLDL (median change -17.8 vs. -8.1 nmol/l, P=0.002), large LDL (mean within person change -167.9 vs. -48.6 nmol/l, P<0.001) and medium LDL (median within person change -101.8 vs. -22.3 nmol/l, P=0.017). Atorvastatin therapy was also associated with a greater increase in large HDL than placebo (median change 1.40 vs. 0.80 micromol/l, P=0.02) and there was little change in small HDL so that average HDL particle size increased significantly with atorvastatin (P=0.04). In addition to reducing levels of (enzymatically measured) triglyceride, LDL-cholesterol and apolipoprotein B in diabetic patients, atorvastatin significantly reduces NMR measured medium and small VLDL and large and medium LDL, and increases large HDL.

KW - Aged

KW - Atorvastatin Calcium

KW - Diabetes Mellitus, Type 2/complications

KW - Double-Blind Method

KW - Female

KW - Heptanoic Acids/administration & dosage

KW - Humans

KW - Hydroxymethylglutaryl-CoA Reductase Inhibitors/administration & dosage

KW - Hyperlipidemias/complications

KW - Lipoproteins, HDL/blood

KW - Lipoproteins, LDL/blood

KW - Lipoproteins, VLDL/blood

KW - Magnetic Resonance Spectroscopy

KW - Male

KW - Middle Aged

KW - Myocardial Ischemia/complications

KW - Patient Compliance

KW - Probability

KW - Pyrroles/administration & dosage

KW - Reference Values

KW - Risk Assessment

KW - Treatment Outcome

U2 - 10.1016/S0021-9150(02)00428-8

DO - 10.1016/S0021-9150(02)00428-8

M3 - Article

C2 - 12818407

VL - 167

SP - 243

EP - 255

JO - Atherosclerosis

JF - Atherosclerosis

SN - 0021-9150

IS - 2

ER -