Type 2 Diabetic Patients Maintained on Statin Therapy
Type 2 Diabetic Patients Maintained on Statin Therapy
Patients with diabetes mellitus (DM) are at increased risk of atherosclerotic cardiovascular
 disease (ACVD). The achievement of the LDL-C target with statins for the reduction of ACVD
 risk is recommended. However, the risk is still present. Therefore, we investigated the
 impact of high sensitivity C-reactive protein (hsCRP), sortilin, adiponectin and leptin
 biomarkers that linking inflammatory hypothesis of diabetes mellitus and atherosclerosis in
 diabetic patients treated with rosuvastatin and atrovastatin. Methods: Based on exclusion
 criteria, 150 type 2 diabetic patients were eligible and randomly assigned to receive either
 40 mg per day atorvastatin (ATROVA group, n= 80) or 10 mg per day rosuvastatin (ROSUVA group,
 n= 80) for 6 months.
a prospective, double blind trial, conducted between January 2018 and January 2020.
 Participants were enrolled if they had moderate cardiovascular risk (Framingham risk score of
 10-20%), in other words 2 or more major risk factors for coronary artery disease (CAD), and
 LDL-cholesterol level ≥100 mg/dl. All patients gave informed consent before entering the
 study. Of 150 patients were randomly assigned to receive either 40 mg per day atorvastatin
 tablets (ATROVA group, n= 80) or 10 mg per day Rosuvastatin (Rosuvastatin Calcium®,
 Chemipharm Co. Cairo, Egypt) tablets (ROSUVA group, n= 80) as recommended in NCEP ATP III
 (21). Patients included in the study were maintained on oral hypoglycemic agents (OHA)
 according to their treatment regimen. Clinical and biochemical assessment was done at
 baseline and after 6 months. Serum High-sensitivity CRP (hsCRP), sortilin, Adiponectin and
 Leptin level was determined using ELISA Kit. Blood pressure (BP) and anthropometrical
 parameters, such as body-mass index (BMI) were calculated using the equation (BMI = weight
 (kg)/height (m2). Blood pressure was measured twice, after keeping participants in a sitting
 position for 15 min. The mean value of two consecutive measurements with 5 min intervals was
 used for study purposes. HbA1c% was determined by ion exchange method. Serum triglycerides
 (TGs), total cholesterol (TCH), and high-density lipoprotein cholesterol (HDL-C) were
 determined colorimetrically. Low-density lipoprotein-cholesterol (LDL-C) was calculated
 according to Friedewald formula. Atherogenic Index (AI) is calculated through the following:
 Atherogenic Index = TCH/HDL-C as TCH/HDL-C ratio is an excellent CVD risk predictor and a
 good biomarker for deciding on the intensity and the need for therapeutic intervention.
Inclusion Criteria:

 -  type II diabetic patients with hypercholesterolemia

 Exclusion Criteria:

 -  liver impairment,

 -  renal insufficiency,

 -  coronary artery disease,

 -  metabolic disorders,

 -  type I diabetes,

 -  autoimmune diseases, cancer, infection,

 -  use of anti-inflammatory drugs,

 -  recent major surgery,

 -  weight-loss or modified anti-hypertensive medications 12 weeks or less prior to
 enrolment,

 -  ongoing or previous use of lipid-lowering medications (including other statins, fibric
 acid derivatives, nicotinic acid, cholestyramine, ezetimibe or omega-3 fatty acids)
 and contraindications to the use of statins.