The Effects Of Atorvastatin On The Level Of Endothelial Microparticles And Carotid Intima Media Thickness In Type 2 Diabetes Mellitus

Diabetes is one of key risk factor for accelerated atherosclerosis(atherosclerosis, As)and its complications become a major cause of death and disability for patients, and endothelial dysfunction is to promote diabetes as the critical path in the process of occurrence and development.Thus, reducing endothelial dysfunction at early stage ought to be an efficient pathway of prevention and cure of As.Endothelial microparticle(EMP) are particles released from endothelial cells over its course of activation or apoptosis, comprising specific cell membrane, nucleus and cytoplasmic structures of the precursor cells and carrying unique biological information. The recent research suggested that a significant increase of EMP in some disease that is closely related to endothelial dysfunction including diabetes, As, autoimmune diseases and inflammatory diseases. The mechanisms of EMP on occurrence and development of diabetic vascular disease still need to be elusive in community. Meanwhile, treatment of these kinds of disease targeting EMP is largely unknown. In addition, there is still controversy about reaction after applying statins in the treatment of EMP. The thickening of carotid intima-media thickness(IMT) thickening is an early-stage indications of As, and be used as a reliable indicator of the evaluation of drug efficacy.Here, we evaluate the dynamics of EMP, low-density lipoprotein cholester(LDL-C) and IMT, and relationship among their effects before and after applying statins medicine on type 2 diabetes mellitus(T2DM)patients. Furthermore, we compare the efficacy of Atorvastatin and simvastatin. To select 90 cases of type 2 diabetes mellitus resident patients,aged between 45 and 75 years old,which were randomly classified into theatorvastatin group and simvastatin group. Under the circumstance of the intervention of life style, all patients undertook oral antidiabetic drug and/or insulin therapy simultaneously, and with aspirin 0.1g qd.Atorvastatin group was given atorvastatin 20 mg more every night,simvastatin group was given simvastatin 20 mg more every night. The entire course of treatment lasted 24 weeks.The level of EMP,low density lipoprotein cholester(LDL-C), IMT was detected before and after the treatment,and the correlation between them was analyze statistically.The results show, in the atorvastatin group and simvastatin group,the IMT decreased significantly( P < 0. 05) after therapy, while the plasma concentration of EMP,LDL-C were decreased( P < 0. 05),and the ability of atorvastatin lowering IMT, EMP and LDL-C was stronger compared to the effect of simvastatin.Linear correlation analysis showed that, there is positive relationship existing in the values of EMP and IMT between the two groups before and after the therapy, atorvastatin group r=0.483,P < 0.05, simvastatin group r=0.423, P ﹤ 0.05; there is positive relationship existing in the values of LDL-C and IMT between the two groups before and after the therapy, atorvastatin group r=0.512,P < 0. 05, simvastatin group r=0.483,P﹤0.05.These results indicated that statins was capable of reducing the IMT,LDL-C and EMP in T2 DM patients.Its anti-atherogenic ability was not only associated with the lipid-lowering effect,but also might be related to the inhibition of EMP release. Atorvastatin was superior compared to simvastatin on reducing both LDL-C and EMP,which might account for the phenomenon of the atherosclerosis resistant of atorvastatin stronger compared to simvastatin.