Non-insulin-dependent diabetes mellitus (
NIDDM) is often characterized by an increase in
VLDL-triglyceride,
VLDL-cholesterol,
LDL-cholesterol and a reduction in
HDL-cholesterol.
HMG-CoA reductase inhibitors significantly lower
cholesterol rates and have an indirect effect on the
LDL receptor. We measured the effect of
simvastatin in 28 hypercholesterolemic subjects, including 14 with
NIDDM in good metabolic control (HbAIc 7.8% +/- 1.3%). A 24-week treatment with 10 mg/day (weeks 1-4), 20 mg/day (weeks 5-8) and 40 mg/day (weeks 9-24)
simvastatin revealed different responses in diabetic and non-diabetic patients. Total
cholesterol, LDL-
cholesterol and
apo B decreased significantly in both groups (less in the diabetics), whereas only
NIDDM patients displayed a significant reduction in
VLDL-cholesterol and VLDL-
apo B. In the non-diabetics, the reduction in plasma
cholesterol was mainly confined to the
LDL fraction (276 +/- 65 vs. 132 +/- 28 mg/dl), whereas a significant fall in
VLDL-cholesterol (45 +/- 19 vs. 21 +/- 10 mg/dl) was more evident in the
NIDDM patients.
Simvastatin also influenced plasma
apo B levels (221 +/- 33 vs 134 +/- 23 mg/dl in non-diabetics and 182 +/- 44 vs. 134 +/- 30 mg/dl in diabetics). Significant reduction of
apo B,
LDL-
apo B (205 +/- 39 vs. 128 +/- 23 mg/dl) in the non-diabetics and VLDL-
apo B (16 +/- 5 vs. 9 +/- 2 mg/dl) in the diabetics, indicates that the VLDL are primarily concerned when
statins are administered in
NIDDM.(ABSTRACT TRUNCATED AT 250 WORDS)