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Abbasalizadeh F, Saleh P, Dousti R, Piri R, Naghavi-Behzad M, Abbasalizadeh S. Effects of atorvastatin on proteinuria of type 2 diabetic nephropathy in patients with history of gestational diabetes mellitus: A clinical study. Niger Med J 2017; 58:63-67. [PMID: 29269983 PMCID: PMC5726175 DOI: 10.4103/0300-1652.219348] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Background Gestational diabetes is known as one of the diseases through pregnancy. In the present study, changes in proteinuria after atorvastatin administration among patients with history of gestational diabetes were studied. Materials and Methods In this randomized clinical trial, 42 patients were included in the study. Atorvastatin was administered for 21 patients, and 21 patients were designated as control group. Lipid profile, protein, and 24 h urine creatinine (uCr) levels were determined in the beginning and 3 months after intervention. P < 0.05 was considered statistically significant. Results Lipid profile in intervention group was enhanced; low-density lipoprotein (LDL) had decreased while triglyceride had not changed and high-density lipoprotein had been increased. There was no statistically significant change in serum Cr, serum urea, estimated glomerular filtration rate, uCr, urine volume, 24-h urine protein level, or urine protein/Cr ratio on both groups during the study; also, there was no statistically significant difference between groups. Conclusions Although LDL level decreased after atorvastatin therapy, atorvastatin therapy had no effect on the level of proteinuria or other parameters related to kidney function.
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Affiliation(s)
- Fatemeh Abbasalizadeh
- Department of Gynecology and Obstetrics, Women's Reproductive Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Parviz Saleh
- Chronic Kidney Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Rana Dousti
- Department of Nursing and Midwifery, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Reza Piri
- Medical Philosophy and History Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | | | - Shamsi Abbasalizadeh
- Department of Gynecology and Obstetrics, Women's Reproductive Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
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2
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Sadighi A, Safa J, Vatankhah AM, Ghorashi S, Aharilahagh A, Davari-Farid S, Nezami-Nargabad O, Naghavi-Behzad M, Piri R, Pishahang P, Babapoor-Farrokhran S, Fakour S, Ghodratnezhad-Azar N. Short-term effects of lovastatin therapy on proteinuria of type 2 diabetic nephropathy: A clinical trial study. Niger Med J 2016; 57:253-259. [PMID: 27833243 PMCID: PMC5036295 DOI: 10.4103/0300-1652.190600] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
Background: Diabetic nephropathy (DN) is characterized by albuminuria, hypertension, and a progressive decline in glomerular filtration rate. The 3-hydroxy-3-methylglutaryl coenzyme A is a well-known agent that is active in lowering total plasma and low-density lipoprotein cholesterol (LDL-C) levels in cases with hypercholesterolemia. Hence, in this study, proteinuria changes at the beginning and after the withdrawal of lovastatin in patients with type 2 DN (T2DN) were studied. Materials and Methods: Lovastatin was administered for thirty male patients with T2DN and then was withdrawn. Twenty-four hours, urine creatinine and protein levels were determined. Results: The mean levels of total cholesterol and LDL-C were reduced without any change in the triglyceride (TG) level while the high-density lipoprotein cholesterol (HDL-C) level was increased. There was a reverse linear correlation between the changes in the level of HDL-C and the changes in the level of 24 h urine protein after 90 days of lovastatin therapy (P = 0.007, r = −0.484). Conclusions: Short-term 3-month lovastatin therapy has no effect on proteinuria levels in patients with T2DN despite the antihyperlipidemic effects and reverse correlation of proteinuria with HDL-C.
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Affiliation(s)
- Alireza Sadighi
- Department of Neurosurgery, University of Wisconsin-Madison, Madison, WI, USA
| | - Javid Safa
- Department of Nephrology, Tabriz University of Medical Sciences, Tabriz, Iran
| | | | - Sona Ghorashi
- Young Researchers Club, Tabriz Branch, Islamic Azad University, Tabriz, Iran
| | - Aida Aharilahagh
- Department of Biology, Montgomery College, Rockville, Maryland, USA
| | - Sina Davari-Farid
- Department of Nephrology, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Ourmaan Nezami-Nargabad
- Department of Internal Medicine, Golestan University of Medical Sciences, Gorgan, Golestan, Iran
| | - Mohammad Naghavi-Behzad
- Medical Philosophy and History Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Reza Piri
- Students' Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Parinaz Pishahang
- Department of Internal Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | | | - Sanam Fakour
- Medical Philosophy and History Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
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3
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Abstract
Diabetic nephropathy (DN), a leading cause of end-stage renal disease (ESRD) affecting ∼20-30% diabetics, is associated with increased cardiovascular mortality. The progression of kidney disease in patients with diabetes can take many years. It occurs as a result of interaction between both genetic and environmental factors in individuals with both type 1 and type 2 diabetes. Hyperglycaemia, hypertension, and genetic pre-disposition are the main risk factors besides elevated serum lipids, smoking habits, and the amount of dietary proteins. Interventions such as glycaemic control, blood pressure control and inhibition of the renin-angiotensin-aldosterone system have been shown to slow this progression. Despite the implementation of these strategies, the number of patients with diabetes that ultimately develop end-stage renal disease remains high. The treatment of DN, therefore, has posed a formidable challenge besides optimization of renin-angiotensin-aldosterone system blockade in patients with DN; additional investigation has focused on the potential of novel therapies that target various pathways upregulated by hyperglycaemia or other targets believed to promote the progression of DN such as oxidative stress, inflammation, endothelin system and vitamin D receptors. This review article addresses the pathogenesis and some of the well established principles regarding the progression and accepted management of DN, and also includes the perspectives of novel anti-DN agents and the future directions for the prevention of DN.
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Affiliation(s)
- Jamal Ahmad
- Rajiv Gandhi Centre for Diabetes and Endocrinology, Faculty of Medicine, J.N. Medical College, Aligarh Muslim University, Aligarh 202002, India.
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de Zeeuw D, Anzalone DA, Cain VA, Cressman MD, Heerspink HJL, Molitoris BA, Monyak JT, Parving HH, Remuzzi G, Sowers JR, Vidt DG. Renal effects of atorvastatin and rosuvastatin in patients with diabetes who have progressive renal disease (PLANET I): a randomised clinical trial. Lancet Diabetes Endocrinol 2015; 3:181-90. [PMID: 25660356 DOI: 10.1016/s2213-8587(14)70246-3] [Citation(s) in RCA: 94] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
BACKGROUND The role of lipid-lowering treatments in renoprotection for patients with diabetes is debated. We studied the renal effects of two statins in patients with diabetes who had proteinuria. METHODS PLANET I was a randomised, double-blind, parallel-group trial done in 147 research centres in Argentina, Brazil, Bulgaria, Canada, Denmark, France, Hungary, Italy, Mexico, Romania, and the USA. We enrolled patients with type 1 or type 2 diabetes aged 18 years or older with proteinuria (urine protein:creatinine ratio [UPCR] 500-5000 mg/g) and taking stable angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, or both. We randomly assigned participants to atorvastatin 80 mg, rosuvastatin 10 mg, or rosuvastatin 40 mg for 52 weeks. The primary endpoint was change from baseline to week 52 of mean UPCR in each treatment group. The study is registered with ClinicalTrials.gov, number NCT00296374. FINDINGS We enrolled 353 patients: 118 were assigned to rosuvastatin 10 mg, 124 to rosuvastatin 40 mg, and 111 to atorvastatin 80 mg; of these, 325 were included in the intention-to-treat population. UPCR baseline:week 52 ratio was 0·87 (95% CI 0·77-0·99; p=0·033) with atorvastatin 80 mg, 1·02 (0·88-1·18; p=0·83) with rosuvastatin 10 mg, and 0·96 (0·83-1·11; p=0·53) with rosuvastatin 40 mg. In a post-hoc analysis to compare statins, we combined data from PLANET I with those from PLANET II (a similar randomised parallel study of 237 patients with proteinuria but without diabetes; registered with ClinicalTrials.gov, NCT00296400). In this analysis, atorvastatin 80 mg lowered UPCR significantly more than did rosuvastatin 10 mg (-15·6%, 95% CI -28·3 to -0·5; p=0·043) and rosuvastatin 40 mg (-18·2%, -30·2 to -4·2; p=0·013). Adverse events occurred in 69 (60%) of 116 patients in the rosuvastatin 10 mg group versus 79 (64%) of 123 patients in the rosuvastatin 40 mg group versus 63 (57%) of 110 patients in the atorvastatin 80 mg group; renal events occurred in nine (7·8%) versus 12 (9·8%) versus five (4·5%). INTERPRETATION Despite high-dose rosuvastatin lowering plasma lipid concentrations to a greater extent than did high-dose atorvastatin, atorvastatin seems to have more renoprotective effects for the studied chronic kidney disease population. FUNDING AstraZeneca.
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Affiliation(s)
- Dick de Zeeuw
- Department of Clinical Pharmacy and Pharmacology, University of Groningen, University Medical Center Groningen, Groningen, Netherlands.
| | | | | | - Michael D Cressman
- Cardiovascular/Metabolic Unit, Covance, Princeton, NJ, USA (formerly AstraZeneca, Wilmington, DE, USA)
| | - Hiddo J Lambers Heerspink
- Department of Clinical Pharmacy and Pharmacology, University of Groningen, University Medical Center Groningen, Groningen, Netherlands
| | - Bruce A Molitoris
- Department of Nephrology, Indiana University School of Medicine, Indianapolis, IN, USA
| | | | - Hans-Henrik Parving
- Department of Medical Endocrinology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark; Faculty of Health Science, Aarhus University, Aarhus, Denmark
| | - Giuseppe Remuzzi
- IRCCS-Istituto di Ricerche Farmacologiche Mario Negri, Bergamo, Italy
| | - James R Sowers
- Diabetes and Cardiovascular Center, University of Missouri, Columbia, MO, USA
| | - Donald G Vidt
- Department of Nephrology and Hypertension, Cleveland Clinic, Cleveland, OH, USA
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Hanai K, Babazono T, Takemura S, Toyonaga A, Yoshida N, Uchigata Y. Comparative Effects of Statins on the Kidney Function in Patients with Type 2 Diabetes. J Atheroscler Thromb 2015; 22:618-27. [DOI: 10.5551/jat.26823] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Affiliation(s)
- Ko Hanai
- Diabetes Center, Tokyo Women’s Medical University School of Medicine
| | - Tetsuya Babazono
- Diabetes Center, Tokyo Women’s Medical University School of Medicine
| | - Shunsuke Takemura
- Diabetes Center, Tokyo Women’s Medical University School of Medicine
| | - Aiko Toyonaga
- Diabetes Center, Tokyo Women’s Medical University School of Medicine
| | - Noriko Yoshida
- Diabetes Center, Tokyo Women’s Medical University School of Medicine
| | - Yasuko Uchigata
- Diabetes Center, Tokyo Women’s Medical University School of Medicine
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Kostapanos MS, Rizos CV, Elisaf MS. Benefit–Risk Assessment of Rosuvastatin in the Treatment of Atherosclerosis and Related Diseases. Drug Saf 2014; 37:481-500. [PMID: 24788803 DOI: 10.1007/s40264-014-0169-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Affiliation(s)
- Michael S Kostapanos
- Department of Internal Medicine, Medical School, University of Ioannina, St. Niarchou Avenue, 45110, Ioannina, Greece
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Oh J, Kang SM, Hong N, Youn JC, Park S, Lee SH, Choi D. Effect of High-Dose Statin Loading on Biomarkers Related to Inflammation and Renal Injury in Patients Hospitalized With Acute Heart Failure. Circ J 2014; 78:2447-54. [DOI: 10.1253/circj.cj-14-0670] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Jaewon Oh
- Cardiology Division, Severance Cardiovascular Hospital and Cardiovascular Research Institute, Yonsei University College of Medicine
| | - Seok-Min Kang
- Cardiology Division, Severance Cardiovascular Hospital and Cardiovascular Research Institute, Yonsei University College of Medicine
| | - Namki Hong
- Cardiology Division, Severance Cardiovascular Hospital and Cardiovascular Research Institute, Yonsei University College of Medicine
| | - Jong-Chan Youn
- Cardiology Division, Severance Cardiovascular Hospital and Cardiovascular Research Institute, Yonsei University College of Medicine
| | - Sungha Park
- Cardiology Division, Severance Cardiovascular Hospital and Cardiovascular Research Institute, Yonsei University College of Medicine
| | - Sang-Hak Lee
- Cardiology Division, Severance Cardiovascular Hospital and Cardiovascular Research Institute, Yonsei University College of Medicine
| | - Donghoon Choi
- Cardiology Division, Severance Cardiovascular Hospital and Cardiovascular Research Institute, Yonsei University College of Medicine
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8
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Effects of atorvastatin and rosuvastatin on renal function: A meta-analysis. Int J Cardiol 2013; 167:2482-9. [DOI: 10.1016/j.ijcard.2012.05.010] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2012] [Revised: 04/16/2012] [Accepted: 05/04/2012] [Indexed: 10/28/2022]
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9
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A meta-analysis of the role of statins on renal outcomes in patients with chronic kidney disease. Is the duration of therapy important? Int J Cardiol 2013; 168:5437-47. [PMID: 24016544 DOI: 10.1016/j.ijcard.2013.08.060] [Citation(s) in RCA: 59] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2013] [Accepted: 08/19/2013] [Indexed: 12/16/2022]
Abstract
INTRODUCTION The efficacy of statin treatment in chronic kidney disease (CKD) patients remains controversial. Therefore, we performed a meta-analysis to investigate whether statins modulate renal function in patients with CKD. METHODS Data from Scopus, PubMed, Web of Science, and the Cochrane Central Register of randomized controlled trials for years 1966-December 2012 were searched for appropriate studies. RESULTS Twenty trials with 6452 CKD subjects randomized to receive either statin or placebo were included. Statin therapy significantly influenced high sensitivity C-reactive protein levels in patients on or off dialysis [-0.28 mg/dl, 95%CI: -0.93 to -0.37; p<0.05 and -0.46 mg/dl, 95%CI: -0.87 to -0.05; p=0.03], respectively], urinary protein (-0.77 g/24 h, 95%CI: -1.24 to -0.29, p<0.02; this effect persisted for treatment ≤12 months), and serum creatinine but only for long-term therapy (3 years) (-0.65 mg/dl, 95%CI: -1.00 to -0.30; p=0.0003). The summary for standardized effect size of mean differences of glomerular filtration rate was 0.29 ml/min/1.73 m(2) (95%CI: 0.01 to 0.58; p=0.04), and depended on treatment duration - a significant increase was observed for between 1 and 3 years of statin therapy (0.50 ml/min/1.73 m(2), 95%CI: 0.40 to 0.60; p<0.0001), with no significant increase for both ≤1 and >3 years of the therapy. CONCLUSION Statins might exert significant renoprotective effects in CKD patients; however, benefit may depend on the duration of treatment. This is an issue that warrants more definitive investigation. More studies are necessary in dialysis patients to credibly evaluate the renal effects of statin therapy.
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10
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Kostapanos MS, Milionis HJ, Gazi I, Kostara C, Bairaktari ET, Elisaf M. Rosuvastatin Increases α-1 Microglobulin Urinary Excretion in Patients With Primary Dyslipidemia. J Clin Pharmacol 2013; 46:1337-43. [PMID: 17050799 DOI: 10.1177/0091270006292629] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
The renoprotective effect of statins has been recently disputed because of observations of proteinuria associated with rosuvastatin treatment, the newest drug of the class. Statin-induced proteinuria findings were mainly based on crudely quantitative dipstick assays. The authors quantitatively evaluated the effect of rosuvastatin at the recommended starting dose of 10 mg/d, on urine protein excretion in patients with primary dyslipidemia. Serum lipid and nonlipid parameters as well as urinary electrolyte, creatinine, and protein (total, albumin, immunoglobulin G, and alpha-1 microglobulin) levels were measured in 40 patients treated with rosuvastatin and 30 controls at baseline and after 12 weeks. The protein-to-creatinine ratios were used to assess urinary protein excretion. Rosuvastatin improved the lipid profile, produced no deterioration of kidney function, but induced a small but significant increase in the excretion of alpha-1 microglobulin (by 16%, P < .05) indicating that statin-related proteinuria involves low-molecular-weight proteins and is of proximal tubular origin.
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Affiliation(s)
- Michael S Kostapanos
- Department of Internal Medicine, School of Medicine, University of Ioannina, 451 10 Ioannina, Greece
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11
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Paulsen L, Matthesen SK, Bech JN, Starklint J, Pedersen EB. Acute Effects of Atorvastatin on Glomerular Filtration Rate, Tubular Function, Blood Pressure, and Vasoactive Hormones in Patients With Type 2 Diabetes. J Clin Pharmacol 2013; 50:816-22. [DOI: 10.1177/0091270009350627] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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12
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Mori H, Okada Y, Tanaka Y. Effects of pravastatin, atorvastatin, and rosuvastatin in patients with type 2 diabetes mellitus and hypercholesterolemia. Diabetol Int 2013. [DOI: 10.1007/s13340-012-0103-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Mitsiou EK, Athyros VG, Karagiannis A, Mikhailidis DI. Is there a role for hypolipidaemic drug therapy in the prevention or treatment of microvascular complications of diabetes? Open Cardiovasc Med J 2012; 6:28-32. [PMID: 22481984 PMCID: PMC3319909 DOI: 10.2174/1874192401206010028] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2012] [Accepted: 02/13/2012] [Indexed: 02/06/2023] Open
Affiliation(s)
- Eydoxia K Mitsiou
- Second Propedeutic Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, Hippocration Hospital, Thessaloniki, Greece
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van der Tol A, Van Biesen W, Van Laecke S, Bogaerts K, De Lombaert K, Warrinnier H, Vanholder R. Statin use and the presence of microalbuminuria. Results from the ERICABEL trial: a non-interventional epidemiological cohort study. PLoS One 2012; 7:e31639. [PMID: 22359611 PMCID: PMC3281099 DOI: 10.1371/journal.pone.0031639] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2011] [Accepted: 01/10/2012] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Microalbuminuria (MAU) is considered as a predictor or marker of cardiovascular and renal events. Statins are widely prescribed to reduce cardiovascular risk and to slow down progression of kidney disease. But statins may also generate tubular MAU. The current observational study evaluated the impact of statin use on the interpretation of MAU as a predictor or marker of cardiovascular or renal disease. METHODOLOGY/PRINCIPAL FINDINGS We used cross-sectional data of ERICABEL, a cohort with 1,076 hypertensive patients. MAU was defined as albuminuria ≥20 mg/l. A propensity score was created to correct for "bias by indication" to receive a statin. As expected, subjects using statins vs. no statins had more cardiovascular risk factors, pointing to bias by indication. Statin users were more likely to have MAU (OR: 2.01, 95%CI: 1.34-3.01). The association between statin use and MAU remained significant after adjusting for the propensity to receive a statin based on cardiovascular risk factors (OR: 1.82, 95%CI: 1.14-2.91). Next to statin use, only diabetes (OR: 1.92, 95%CI: 1.00-3.66) and smoking (OR: 1.49, 95%CI: 0.99-2.26) were associated with MAU. CONCLUSIONS Use of statins is independently associated with MAU, even after adjusting for bias by indication to receive a statin. In the hypothesis that this MAU is of tubular origin, statin use can result in incorrect labeling of subjects as having a predictor or marker of cardiovascular or renal risk. In addition, statin use affected the association of established cardiovascular risk factors with MAU, blurring the interpretation of multivariable analyses.
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Affiliation(s)
- Arjan van der Tol
- Renal Division, Department of Internal Medicine, University Hospital Ghent, Ghent, Belgium.
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15
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Chadban S, Howell M, Twigg S, Thomas M, Jerums G, Cass A, Campbell D, Nicholls K, Tong A, Mangos G, Stack A, MacIsaac RJ, Girgis S, Colagiuri R, Colagiuri S, Craig J. The CARI guidelines. Prevention and management of chronic kidney disease in type 2 diabetes. Nephrology (Carlton) 2012; 15 Suppl 1:S162-94. [PMID: 20591029 DOI: 10.1111/j.1440-1797.2010.01240.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Wu Y, Wang Y, An C, Dong Z, Liu H, Zhang Y, Zhang M, An F. Effects of Rosuvastatin and Atorvastatin on Renal Function. Circ J 2012; 76:1259-66. [DOI: 10.1253/circj.cj-11-1385] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Yongxia Wu
- Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education and Chinese Ministry of Health, Shandong University Qilu Hospital
| | - Yan Wang
- Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education and Chinese Ministry of Health, Shandong University Qilu Hospital
| | - Chuankai An
- School of Electronics Engineering and Computer Science, Peking University
| | - Zhe Dong
- Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education and Chinese Ministry of Health, Shandong University Qilu Hospital
| | - Hui Liu
- Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education and Chinese Ministry of Health, Shandong University Qilu Hospital
| | - Yun Zhang
- Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education and Chinese Ministry of Health, Shandong University Qilu Hospital
| | - Mingxiang Zhang
- Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education and Chinese Ministry of Health, Shandong University Qilu Hospital
| | - Fengshuang An
- Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education and Chinese Ministry of Health, Shandong University Qilu Hospital
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17
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A meta-analysis of randomized trials for effects of atorvastatin on renal function in chronic kidney disease. Int J Cardiol 2011; 152:242-4. [PMID: 21764159 DOI: 10.1016/j.ijcard.2011.06.107] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2011] [Accepted: 06/25/2011] [Indexed: 12/15/2022]
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18
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Kostapanos MS, Milionis HJ, Elisaf MS. An overview of the extra-lipid effects of rosuvastatin. J Cardiovasc Pharmacol Ther 2008; 13:157-74. [PMID: 18460672 DOI: 10.1177/1074248408318628] [Citation(s) in RCA: 53] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Statins, in addition to their beneficial lipid modulation effects, exert a variety of several so-called "pleiotropic" actions that may result in clinical benefits. Rosuvastatin, the last agent of the class to be introduced, has proved remarkably potent in reducing low-density lipoprotein cholesterol levels. At present, no large-scale primary or secondary prevention clinical trials document either its long-term safety or its effectiveness in preventing cardiovascular events. A substantial number of experimental and clinical studies have indicate favorable effects of rosuvastatin on endothelial function, oxidized low-density lipoprotein, inflammation, plaque stability, vascular remodeling, hemostasis, cardiac muscle, and components of the nervous system. Available data regarding the effects of rosuvastatin on renal function and urine protein excretion do not seem to raise any safety concerns. Whether the established "pleiotropy" and/or lipid-lowering efficacy of rosuvastatin may translate into reduced morbidity and mortality remains to be shown in ongoing clinical outcome trials.
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Affiliation(s)
- Michael S Kostapanos
- Department of Internal Medicine, School of Medicine, University of Ioannina, Ioannina, Greece
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19
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Schuster H, Palmer MK, Ditmarsch M. The MERCURY I open-label extension study — subgroup analysis in patients with diabetes. ACTA ACUST UNITED AC 2008. [DOI: 10.1177/14746514080080030601] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background The MERCURY I open-label extension study provides safety and efficacy data on hypercholesterolaemic patients with type 2 diabetes treated with rosuvastatin for up to three years. Methods A total of 2,492 hypercholesterolaemic patients, including 665 (26.7%) with type 2 diabetes, on rosuvastatin 10 mg or 20 mg were followed for a mean of 672 days in an open-label extension study during which the dose could be increased to 20 or 40 mg to reach the 1998 European low-density lipoprotein-cholesterol (LDL-C) target of < 3.0 mmol/L (< 115 mg/dL) Results Most diabetic and non-diabetic patients started (85.4 % and 88.7%) and finished (78.3% and 77.6%) on rosuvastatin 10 mg. Adverse event (9.8% and 12.3%) and treatment discontinuation (2.2% and 3.5%) rates were similar in diabetic and non-diabetic patients. No myopathy or rhabdomyolysis was observed. Mean serum creatinine decreased in both subgroups. Proteinuria was reported as an adverse event in five (0.7%) diabetic patients and eight (0.4%) non-diabetic patients. Fasting plasma glucose did not change markedly in either subgroup. LDL-C decreased by 51.1% and 47.4% in diabetic and non-diabetic patients, respectively, with 92.4% and 90.3% reaching target LDL-C. Conclusion Long-term rosuvastatin treatment is effective and well tolerated in diabetic patients.
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Crouse JR. An evaluation of rosuvastatin: pharmacokinetics, clinical efficacy and tolerability. Expert Opin Drug Metab Toxicol 2008; 4:287-304. [DOI: 10.1517/17425255.4.3.287] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
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Fujita H, Koshimura J, Sato T, Miura T, Sasaki H, Morii T, Narita T, Kakei M, Ito S, Yamada Y. Effects of long-term pravastatin treatment on serum and urinary monocyte chemoattractant protein-1 levels and renal function in type 2 diabetic patients with normoalbuminuria. Ren Fail 2008; 29:791-6. [PMID: 17994445 DOI: 10.1080/08860220701543056] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
Abstract
To explore the renoprotective and anti-inflammatory effects of pravastatin, we analyzed the changes in renal function and urinary monocyte chemoattractant protein-1 (MCP-1) level as a renal tubulointerstitial inflammatory biomarker and serum MCP-1 level as a systemic inflammatory biomarker following the introduction of treatment with 10 mg/day of pravastatin in 10 hyperlipidemic type 2 diabetic patients with normoalbuminuria. Twelve months of the pravastatin treatment did not affect urinary levels of albumin, transferrin, N-acetylglucosaminidase, or MCP-1 in the hyperlipidemic diabetic patients, whereas the treatment significantly reduced serum levels of MCP-1 in the patients. The pravastatin treatment effectively lowered low-density lipoprotein cholesterol (LDL-C) levels in the hyperlipidemic diabetic patients to levels nearly to those in 11 non-hyperlipidemic type 2 diabetic patients with normoalbuminuria. Interestingly, serum MCP-1 levels were significantly lower in the hyperlipidemic patients treated with pravastatin than in the non-hyperlipidemic patients. No significant correlation was observed between serum LDL-C and MCP-1 levels in all the data in the hyperlipidemic patients before and after the pravastatin treatment and in the non-hyperlipidemic patients. These results collectively indicate that pravastatin may ameliorate systemic vascular inflammation rather than local renal inflammation in hyperlipidemic type 2 diabetic patients with normoalbuminuria, independent of its cholesterol-lowering effects.
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Affiliation(s)
- Hiroki Fujita
- Division of Endocrinology, Metabolism and Geriatric Medicine, Department of Internal Medicine, Akita University School of Medicine, Akita, Japan.
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Gonzalez GL, Manrique CM, Sowers JR. High Cardiovascular Risk in Patients With Diabetes and the Cardiometabolic Syndrome: Mandate for Statin Therapy. ACTA ACUST UNITED AC 2006; 1:178-83. [PMID: 17679817 DOI: 10.1111/j.1559-4564.2006.05672.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Diabetes mellitus confers a high risk of cardiovascular morbidity and mortality and requires aggressive management of all cardiovascular risk factors, including diabetic dyslipidemia. Although levels of low-density lipoprotein cholesterol are often normal or only slightly elevated in persons with diabetes, lipid-altering therapy with statins has been shown in large, randomized, controlled trials to decrease the risk of cardiovascular complications in this patient population. A target low-density lipoprotein cholesterol level of <70 mg/dL is now a therapeutic option in patients at very high risk for coronary heart disease, including patients with diabetes. Diabetes is also a leading cause of end-stage renal disease. In addition to their lipid-modifying effects, statins have been shown to slow the progression of diabetic nephropathy and potentially exert other renoprotective effects; these benefits, however, remain to be confirmed in clinical trials.
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