Interference Of Atorvastatin With The Risk Factors Of Atherosclerosis In Impaired Glucose Tolerance Patients

Objective:Intima-media thickness(IMT)of carotid artery is a sensitive,reliable, and non-invasive index of early stage atherosclerosis.To determine the risk factor of early stage atherosclerosis in impaired glucose tolerance(IGT)patients and evaluate the interference mechanisms of atorvastatin with the risk factor of atherosclerosis in IGT patients.Methods:One hundred patients were divided into 2 groups;experimental group (IGT,n=50)and control group(non IGT/NGT,n=50).Both groups underwent high-frequency Doppler echocardiography to evaluate IMT of carotid artery.Body height,body weight,waist line,hip line,blood pressure,fasting plasma glucose (FPG),two hours plasma glucose(2hPG),fasting insulin(FINS),triglyceride(TG), total cholesterol(TC),low density lipoprotein-cholesterol(LDL-C),high density lipoprotein-cholesterol(HDL-C),high sensitive C-reactive protein(hs-CRP),nitrogen monoxidum(NO),body mass index(BMI),waist-to-hip ratios(WHR),and insulin resistance index with homeostasis model(HOMA-IR)were measured in both groups. Flow-mediated diastolic function of brachial artery was examined using high-frequency echocardiography,which was indicated by diastolic inner diameter changing rate(D%).Analyze the association between those parameters and IMT of carotid artery in IGT group and that of independent risk factor.IGT group was administered by atorvastatin 20 mg/day for 3 months.All parameters were observed before and after drug administration.Analyze the correlation between the changes of carotid-IMT and the other parameters.Results:(1)BMI,WHR,2hPG;TG,LDL-C,hs-CRP,FINS,HOMA-IR,IMT of carotid artery significantly increase in IGT group compared with those of the NGT group.Conversely,NO and D%significantly decrease in IGT group compared with those of the NGT group(P＜0.05,P＜0.01).No significant differences in age,sex, systolic BP,diastolic BP,FPG,TC and HDL-C between two groups(P＞0.05).(2) There was positive correlation between carotid-IMT and age,BMI,WHR,2hPG,TC, LDL-C,hs-CRP,HOMA-IR(P＜0.05,P＜0.01).Inversely,there was negative correlation between carotid-IMT with D%in IGT group(P＜0.01).However, carotid-IMT did not correlate with systolic BP,diastolic BP,FPG,TC and HDL-C, NO(P＞0.05).Linier regression analysis showed that age,WHR,HOMA-IR and D% are independent risk factors for carotid-IMT.(3).After 3-months of Atorvastatin treatment;2hPG,TG,TC,LDL-C,hs-CRP,IMT significantly decrease,NO and D% significantly increase(P＜0.05,P＜0.01)in IGT group.However,no significant differences were found in BMI,WHR,systolic BP,diastolic BP,FPG,FINS,HDL-C and HOMA-IR between before and after Atorvastatin treatment in IGT group (P＞0.05).(4)There was positive correlation between△IMT and△hs-CRP in IGT group,before and after treatment(P＜0.05).Negative correlation was found between△IMT and△D%(P＜0.01)and there was no correlation between△IMT and△TG,△TC,△LDL-C,△HDL-C,△FPG,△2hPG,△FINS,△HOMA-IR,△NO(P＞0.05).Conclusions:IGT patients have already had risk factors of early stage atherosclerosis,including age,concentric obesity,IR,impaired endothelial function as independent risk factors of atherosclerosis that is to be a high risk factors in cardio-neuro-vascular diseases;Statin is considered to prevent and treat early stage atherosclerosis in IGT patients,through decreased lipid profile,anti-inflammation, improved endothelial function,ameliorate IR and insulinβ-cell function.