Endocrine Abstracts

There is an association between high LDL-Ch levels and cardiovascular disease in T2DM patients. Clinical trials have shown that reduction of LDL-Ch with statins has a beneficial effect on macrovascular complications in patients with T2DM, but is this a relevant effect in clinical practice? LAF has a slower absorption, longer action time and less side effects than other statins.

Objective: To assess in clinical practice, the effect of LAF on LDL-Ch and their action on other serum lipids (SL), according to the European Diabetes Policy Group (EDPG) goals, in T2DM patients in which maximum dose of other statins have failed to achieve the recommended goals.

Material and methods: Four hundred fifty two of 788 patients with T2DM and dyslipidaemia attending our Endocrine Clinic, who were on maximum dose of simvastatin, lovastatin, pravastatin or atorvastatin were selected. Eighty four of them had LDL-Ch levels >115 mg/dl, according the EDPG guidelines, and were included in this study. In these patients we measured total cholesterol (Ch), high density lipoprotein-Ch (HDL-Ch) and triglycerides (TGs), and calculated LDL-Ch, before and after 9 months shift from the previous statin treatment to LAF 80 mg/day. The percent of patients who reached the LDL-Ch target and the mean (±S.D.) values for SL, before and after 9 months LAF treatment were compared. For continous variables a paired samples “t” test, and for categorical variables a related samples MacNemar test were used. All analyses were performed using the SPSS statistical program (versión 6.0). A level of P<0.05 was considered significant.

Results: After 9 months LAF treatment, the 57% of patients achieved the LDL-Ch target according EDPG guidelines (P=0.0000). There was also a significant decrease in mean Ch and LDL-Ch (P=0.000, for two); and an increase in HDL-Ch (P=0.000).

Conclusions: In clinical practice, LAF treatment got the LDL-Ch target, according EDPG, in more than 50% of patients with T2DM in which maximum dose of other statins have failed to achieve the recommended goals. In addition to this effect, the increase in HDL-Ch observed after LAF treatment show the importance of this statin in the treatment of T2DM patients with dyslipidaemia.