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
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Randomized Controlled Trial
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Research Support, Non-U.S. Gov't
MeSH terms
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Administration, Cutaneous
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Adult
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Atorvastatin
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Biomarkers / blood
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Cell-Derived Microparticles / metabolism
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Cross-Over Studies
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Diabetes Mellitus, Type 1 / blood
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Diabetes Mellitus, Type 1 / complications*
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Diabetes Mellitus, Type 1 / diagnosis
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Diabetes Mellitus, Type 1 / physiopathology
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Diabetic Angiopathies / blood
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Diabetic Angiopathies / diagnosis
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Diabetic Angiopathies / etiology*
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Diabetic Angiopathies / physiopathology
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Double-Blind Method
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Dyslipidemias / blood
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Dyslipidemias / complications
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Dyslipidemias / diagnosis
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Dyslipidemias / drug therapy*
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Endothelium, Vascular / drug effects*
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Endothelium, Vascular / metabolism
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Endothelium, Vascular / physiopathology
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Female
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Glycated Hemoglobin / metabolism
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Heptanoic Acids / administration & dosage
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Heptanoic Acids / adverse effects*
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Humans
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Hydroxymethylglutaryl-CoA Reductase Inhibitors / administration & dosage
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Hydroxymethylglutaryl-CoA Reductase Inhibitors / adverse effects*
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Iontophoresis
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Laser-Doppler Flowmetry
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Male
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Microcirculation / drug effects*
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Middle Aged
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Pyrroles / administration & dosage
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Pyrroles / adverse effects*
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Risk Factors
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Skin / blood supply*
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Sweden
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Time Factors
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Treatment Outcome
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Vasodilator Agents / administration & dosage
Substances
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Biomarkers
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Glycated Hemoglobin A
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Heptanoic Acids
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Hydroxymethylglutaryl-CoA Reductase Inhibitors
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Pyrroles
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Vasodilator Agents
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hemoglobin A1c protein, human
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Atorvastatin