Combo May Help Prevent Diabetes
NEW YORK—Using a thiazolidinedione (TZD) drug in combination with a statin may decrease systemic inflammation and reduce the incidence of new-onset diabetes among patients with metabolic syndrome, data suggest.
In a six-month, double-blind, placebo-controlled study, researchers led by George Bakris, MD, Director of the Hypertensive Diseases Unit at the University of Chicago Pritzker School of Medicine, compared simvastatin 40 mg plus placebo with simvastatin 40 mg plus TZD agent rosiglitazone 4 mg in 42 patients with metabolic syndrome. Both statins and TZDs have been shown to have anti-inflammatory properties that protect against development of atherosclerosis, Dr. Bakris' group observed. The primary endpoint of the study was the change in high-sensitivity C-reactive protein (hsCRP), a marker of systemic inflammation.
The combination arm experienced a significant decrease in hsCRP levels compared with the placebo group, the investigators reported at the American Society of Hypertension annual meeting. In the rosiglitazone group, mean hsCRP levels dropped from 1.26 mg/dL at baseline to 0.4 mg/dL at the end of the study. In the placebo group, the level rose from 1.02 to 1.72 mg/dL, a nonsignificant change.
Additionally, the study showed that fasting blood sugar increased by mean of 5.94 mg/dL in the placebo group, whereas it decreased significantly by 4.85 mg/dL in the rosiglitazone arm. Levels of adiponectin, a hormone produced by fat cells that influences the body's response to insulin and which has anti-inflammatory effects on the cells lining the walls of blood vessels, increased significantly from baseline in the rosiglitazone-treated patients but decreased slightly in the placebo recipients.
“Metabolic syndrome is a low grade inflammatory condition that frequently culminates in development of diabetes,” Dr. Bakris said. “Statin therapy clearly improves inflammatory markers, but use of agents shown to alter time to diabetes development [and which] also have independent anti-inflammatory effects have the potential to further slow atherosclerosis development.”