Simvastatin treatment on postprandial hypertriglyceridemia in type 2 diabetes mellitus patients with combined hyperlipidemia

Recent studies have shown that statins are effective in reducing fasting lo w-density lipoprotein-cholesterol (LDL-C) and triglyceride levels. However, it remains unknown if treatment with statins also lowers daily postprandia l triglyceride concentrations, which may promote atherogenesis in type 2 di abetes subjects. Forty-one subjects with type 2 diabetes and combined hyper lipidemia who had stable glycemic control were randomly assigned to take si mvastatin 20 mg (n = 27) or a placebo (n = 14) once daily for 12 weeks. The medication dosage was doubled after 4 weeks if a subject's LDL-C was not l ess than 130 mg/dL. Among these participants, 24 subjects (15 on simvastati n and 9 on placebo) agreed to take a meal tolerance test with isocaloric mi xed meals (carbohydrate, 52%; fat, 33%, and protein, 15% of the daily calor ic intake) and daytime hourly blood sampling from 8 AM to 4 PM. Simvastatin treatment reduced the fasting total cholesterol level from 237 +/- 5 to 17 8 +/- 6 mg/dL (-25%), the LDL cholesterol level from 150 +/- 6 to 87 +/- 5 mg/dL (-40%), and raised high-density lipoprotein-cholesterol (HDL-C) level from 36 +/- 2 to 40 +/- 2 mg/dL (+11%) (all P <.001). Fasting and daily am bient triglyceride concentrations from 8 AM to 4 PM decreased significantly in response to simvastatin administration (P <.001), but not to the placeb o (P =.305). Simvastatin treatment not only decreased total cholesterol and LDL-C levels and increased HDL-C levels effectively, it also decreased fas ting, as well as daily postprandial triglyceride concentrations, but had no effect on glycemic control in type 2 diabetes subjects with combined hyper lipidemia. Copyright (C) 2001 by W.B. Saunders Company.