Impaired endothelium-dependent skin microvascular function during high-dose atorvastatin treatment in patients with type 1 diabetes

Diab Vasc Dis Res. 2013 Nov;10(6):483-8. doi: 10.1177/1479164113491275. Epub 2013 Jul 3.

Abstract

Aims: The present study investigated the effects of lipid-lowering therapy with atorvastatin on skin microvascular function in patients with type 1 diabetes and dyslipidaemia.

Methods: Twenty patients received daily treatment with atorvastatin 80 mg or placebo during 2 months in a randomised, double-blind, cross-over study. Forearm skin microcirculation was investigated with laser Doppler perfusion imaging during iontophoresis of acetylcholine and sodium nitroprusside to assess endothelium-dependent and endothelium-independent microvascular reactivity, respectively. Various biochemical markers of endothelial function were also investigated.

Results: Endothelium-dependent microvascular reactivity decreased during atorvastatin (p < 0.001), showing a significant treatment effect compared with placebo (p = 0.04). Atorvastatin treatment was also associated with increased haemoglobin A1C levels from 7.45% to 7.77% (p = 0.008).

Conclusions: The present study shows impaired endothelium-dependent skin microvascular function during high-dose atorvastatin treatment in patients with type 1 diabetes, thus implicating a risk for deterioration of microvascular function during such therapy in these patients.

Keywords: Statin; microcirculation; type 1 diabetes.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Administration, Cutaneous
  • Adult
  • Atorvastatin
  • Biomarkers / blood
  • Cell-Derived Microparticles / metabolism
  • Cross-Over Studies
  • Diabetes Mellitus, Type 1 / blood
  • Diabetes Mellitus, Type 1 / complications*
  • Diabetes Mellitus, Type 1 / diagnosis
  • Diabetes Mellitus, Type 1 / physiopathology
  • Diabetic Angiopathies / blood
  • Diabetic Angiopathies / diagnosis
  • Diabetic Angiopathies / etiology*
  • Diabetic Angiopathies / physiopathology
  • Double-Blind Method
  • Dyslipidemias / blood
  • Dyslipidemias / complications
  • Dyslipidemias / diagnosis
  • Dyslipidemias / drug therapy*
  • Endothelium, Vascular / drug effects*
  • Endothelium, Vascular / metabolism
  • Endothelium, Vascular / physiopathology
  • Female
  • Glycated Hemoglobin / metabolism
  • Heptanoic Acids / administration & dosage
  • Heptanoic Acids / adverse effects*
  • Humans
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors / administration & dosage
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors / adverse effects*
  • Iontophoresis
  • Laser-Doppler Flowmetry
  • Male
  • Microcirculation / drug effects*
  • Middle Aged
  • Pyrroles / administration & dosage
  • Pyrroles / adverse effects*
  • Risk Factors
  • Skin / blood supply*
  • Sweden
  • Time Factors
  • Treatment Outcome
  • Vasodilator Agents / administration & dosage

Substances

  • Biomarkers
  • Glycated Hemoglobin A
  • Heptanoic Acids
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors
  • Pyrroles
  • Vasodilator Agents
  • hemoglobin A1c protein, human
  • Atorvastatin