The Role Of Intensive Atorvastatin Therapy On Akt/Glut4Expression In The Coronary Heart Disease Patients With Diabetes Mellitus

Objective：In recent decades, the morbidity of the coronary heart disease(CHD)is increasing. The death and morbidity caused by CHD is increasing in the world.Diabetes mellitus(DM) as a coronary heart disease risk equivalent play an importantrole in the cardiovascular disease (CVD). The Atorvastatin is used to accommodateblood lipids, but it’s widely used in people who with diabetes by nonlipid effect.Akt/Glut4as one of the glucose metabolic pathway is used to carry glucose. Inpatients with CHD and DM characterized by abnormal expression of the Akt/Glut4.Statins as a effective treatment medicine in patients who has attacked by CHD andDM. Whether the statins effect on Akt/Glut4’s expression of the glucose metabolicpathway? The aim of this study is investigate the expression of the glucosemetabolic-Akt/Glut4with different doses of atorvastatin who with CHD and DMhas already finished the percutaneous coronary intervention(PCI).Methods:80patients were enrolled in this study who came from the firstaffiliated hospital of dalian medical university for coronary heart disease admittedin June2012to February2013as the research object. Enrolment criteria were:(1)Age<75, CHD had been treatment with PCI after admission.(2)Echocardiographic is normal;(3)Patients has been diagnosed type2diabetesalmost2years, they were taking drugs regularly;(4)Prior to admission the patientshave not taking statins;(5)LDL-C<100mg/dl;(6)Liver function is normal, no historyof cancer. Exclusion criteria were:(1)Cerebral hemorrhage, cerebral infarctionmedical history before.(2)Known allergic to statins,with myositis or muscleweakness.(2)Serum cholesterol level>400mg/dl.The80patients were randomly divided into two groups. There were conventional dose (atorvastatin10mg/day n=40) and high dose (atorvastatin40mg/day n=40). Tested fasting plasma glucose(FPG), blood lipids and usingELISA method to determination of serum Akt/Glut4expression by threetimes(before taken drug, after1month, after3months). Compared differencesamong these groups with SPSS. P value<0.05were considered to be statisticallysignificant difference.Results:(1) Akt：the conventional dose group: before taken drug, after1monthand after3month the expression was no statistically significant difference (P=0.86);the high dose group: after3month VS. before taken drug the level was decline(P=0.03);(2)Glut4: the conventional dose group’s before taken drug, after1monthand after3month the expression was no statistic significant difference (P=0.62);the high dose group: after3months VS before taken drug (P=0.03).(3)Fastingplasma glucose: the conventional dose group and high dose group: after3monthsVS. before the P value were0.85.and0.65;(4)Low density lipoprotein: level of twogroups were both had statistic significant (P values were0.003and0.001.)Conclusions:(1)Intensive atorvastatin therapy can decrease the expression ofAkt/Glut4;(2) Compared with the conventional dose, intensive atorvastatin therapycan make the trend of increasing fasting blood glucose;(3)It is safety andtolerability in intensive atorvastatin therapy used to accommodate low densitylipoprotein.