Improvement in Endothelium Dysfunction in Diabetics Treated with Statins: A Randomized Comparison of Atorvastatin 20 mg versus Rosuvastatin 10 mg

AIM: To investigate the effect a 3-month treatment with atorvastatin 20 mg compared with rosuvastatin 10 mg on endothelium dysfunction in subjects with diabetes. METHODS: A total of 22 consecutive subjects with diabetes who were not receiving statins were enrolled in the study. Endothelium function was assessed before treatment (T0), after 1 month (T1), and after 3 months of treatment (T2) with statins with brachial echo-Doppler test. Patients were randomized to receive atorvastatin 20 mg or rosuvastatin 10 mg. Blood samples were drawn in the meantime in order to evaluate C-reactive protein (CRP) plasmatic concentrations. RESULTS: A total of 82% of patients enrolled showed endothelium dysfunction (hyperemic reserve <5%). Treatment with statins significantly improved endothelium function in diabetics. Subjects with endothelium dysfunction decreased from 82% (T0) to 44% (T2): mean hyperemic reserve values increased from 2.64% (T0) to 3.23% (T1) and 4% (T2) in patients treated with rosuvastatin (ANOVA P < 0.01), and from 2.74% (T0) to 2.75% (T1) and 4.40% (T2) in those treated with atorvastatin (ANOVA P < 0.01); differences were significant only comparing T2 with T0. Relative increase in endothelium reserve was 51.51% with rosuvastatin versus 60.58% with atorvastatin (P N.S.). Both statins significantly reduced plasmatic levels of CRP (3.18 +/- 2.43 mg/dL [T0] vs. 1.31 +/- 1.67 mg/dL [T2] with rosuvastatin [P < 0.01], 7.53 +/- 7.46 mg/dL [T0] vs. 2.92 +/- 2.06 mg/dL [T2] with atorvastatin [P < 0.01]). Relative reduction of CRP levels was -50.57% with rosuvastatin versus -36.28% with atorvastatin (P N.S.). CONCLUSION: A 3-month treatment with either atorvastatin 20 mg or rosuvastatin 10 mg is effective in improving endothelium dysfunction in subjects with diabetes.