Variability of lipids in patients with Type 2 diabetes taking statin treatment: Implications for target setting

T. Sathyapalan, Stephen Atkin, E. S. Kilpatrick

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

Aims: To determine the biological variability of lipids in patients with Type 2 diabetes (T2DM) who are on statin treatment and then to assess any implications for current lipid targets. Methods: A cross-over study of biological variation of lipids in 26 patients with T2DM taking either simvastatin 40 mg or atorvastatin 10 mg. After 3 months on one statin, fasting lipids were measured on 10 occasions over a 5-week period. Following 3 months on the other statin, 10 further samples were taken over 5 weeks. The main outcome measures were biological variability of total cholesterol (TC), low-density lipoprotein (LDL) cholesterol, high-density lipoprotein (HDL) cholesterol and triglycerides. Results: The coefficient of variation (CV) of TC, LDL, HDL and triglycerides on simvastatin was 8.17, 13.11, 7.95 and 12.06%, respectively, whereas the CV on atorvastatin was 6.92, 10.30, 5.13 and 19.71%, respectively, with no statistically significant differences between statins. Treating to sustain a target TC < 5.0 mmol/l or LDL < 3.0 mmol/l means needing to maintain a mean TC of 4.3-4.4 mmol/l or LDL of 2.4-2.5 mmol/l. Treating to consistently achieve an LDL < 2.0 mmol/l means aiming for a mean of only 1.5-1.6 mmol/l. Conclusion: In patients with T2DM taking either simvastatin or atorvastatin, the mean TC and LDL concentrations needed to consistently remain below a target are much lower than the target value itself. This means that guideline target limits extrapolated from the mean values of patients participating in clinical studies may overestimate the lipid reductions required.

Original languageEnglish
Pages (from-to)909-915
Number of pages7
JournalDiabetic Medicine
Volume25
Issue number8
DOIs
Publication statusPublished - Aug 2008
Externally publishedYes

Fingerprint

Hydroxymethylglutaryl-CoA Reductase Inhibitors
Type 2 Diabetes Mellitus
Simvastatin
Lipids
LDL Lipoproteins
LDL Cholesterol
Cholesterol
Therapeutics
HDL Lipoproteins
Cross-Over Studies
HDL Cholesterol
Fasting
Outcome Assessment (Health Care)
Guidelines
Atorvastatin Calcium

Keywords

  • Biological variation
  • Coefficient of variation
  • Lipids
  • Statins
  • Type 2 Diabetes

ASJC Scopus subject areas

  • Endocrinology
  • Endocrinology, Diabetes and Metabolism
  • Internal Medicine

Cite this

Variability of lipids in patients with Type 2 diabetes taking statin treatment : Implications for target setting. / Sathyapalan, T.; Atkin, Stephen; Kilpatrick, E. S.

In: Diabetic Medicine, Vol. 25, No. 8, 08.2008, p. 909-915.

Research output: Contribution to journalArticle

@article{702521a851af4f638555b545a0baa2ea,
title = "Variability of lipids in patients with Type 2 diabetes taking statin treatment: Implications for target setting",
abstract = "Aims: To determine the biological variability of lipids in patients with Type 2 diabetes (T2DM) who are on statin treatment and then to assess any implications for current lipid targets. Methods: A cross-over study of biological variation of lipids in 26 patients with T2DM taking either simvastatin 40 mg or atorvastatin 10 mg. After 3 months on one statin, fasting lipids were measured on 10 occasions over a 5-week period. Following 3 months on the other statin, 10 further samples were taken over 5 weeks. The main outcome measures were biological variability of total cholesterol (TC), low-density lipoprotein (LDL) cholesterol, high-density lipoprotein (HDL) cholesterol and triglycerides. Results: The coefficient of variation (CV) of TC, LDL, HDL and triglycerides on simvastatin was 8.17, 13.11, 7.95 and 12.06{\%}, respectively, whereas the CV on atorvastatin was 6.92, 10.30, 5.13 and 19.71{\%}, respectively, with no statistically significant differences between statins. Treating to sustain a target TC < 5.0 mmol/l or LDL < 3.0 mmol/l means needing to maintain a mean TC of 4.3-4.4 mmol/l or LDL of 2.4-2.5 mmol/l. Treating to consistently achieve an LDL < 2.0 mmol/l means aiming for a mean of only 1.5-1.6 mmol/l. Conclusion: In patients with T2DM taking either simvastatin or atorvastatin, the mean TC and LDL concentrations needed to consistently remain below a target are much lower than the target value itself. This means that guideline target limits extrapolated from the mean values of patients participating in clinical studies may overestimate the lipid reductions required.",
keywords = "Biological variation, Coefficient of variation, Lipids, Statins, Type 2 Diabetes",
author = "T. Sathyapalan and Stephen Atkin and Kilpatrick, {E. S.}",
year = "2008",
month = "8",
doi = "10.1111/j.1464-5491.2008.02519.x",
language = "English",
volume = "25",
pages = "909--915",
journal = "Diabetic Medicine",
issn = "0742-3071",
publisher = "Wiley-Blackwell",
number = "8",

}

TY - JOUR

T1 - Variability of lipids in patients with Type 2 diabetes taking statin treatment

T2 - Implications for target setting

AU - Sathyapalan, T.

AU - Atkin, Stephen

AU - Kilpatrick, E. S.

PY - 2008/8

Y1 - 2008/8

N2 - Aims: To determine the biological variability of lipids in patients with Type 2 diabetes (T2DM) who are on statin treatment and then to assess any implications for current lipid targets. Methods: A cross-over study of biological variation of lipids in 26 patients with T2DM taking either simvastatin 40 mg or atorvastatin 10 mg. After 3 months on one statin, fasting lipids were measured on 10 occasions over a 5-week period. Following 3 months on the other statin, 10 further samples were taken over 5 weeks. The main outcome measures were biological variability of total cholesterol (TC), low-density lipoprotein (LDL) cholesterol, high-density lipoprotein (HDL) cholesterol and triglycerides. Results: The coefficient of variation (CV) of TC, LDL, HDL and triglycerides on simvastatin was 8.17, 13.11, 7.95 and 12.06%, respectively, whereas the CV on atorvastatin was 6.92, 10.30, 5.13 and 19.71%, respectively, with no statistically significant differences between statins. Treating to sustain a target TC < 5.0 mmol/l or LDL < 3.0 mmol/l means needing to maintain a mean TC of 4.3-4.4 mmol/l or LDL of 2.4-2.5 mmol/l. Treating to consistently achieve an LDL < 2.0 mmol/l means aiming for a mean of only 1.5-1.6 mmol/l. Conclusion: In patients with T2DM taking either simvastatin or atorvastatin, the mean TC and LDL concentrations needed to consistently remain below a target are much lower than the target value itself. This means that guideline target limits extrapolated from the mean values of patients participating in clinical studies may overestimate the lipid reductions required.

AB - Aims: To determine the biological variability of lipids in patients with Type 2 diabetes (T2DM) who are on statin treatment and then to assess any implications for current lipid targets. Methods: A cross-over study of biological variation of lipids in 26 patients with T2DM taking either simvastatin 40 mg or atorvastatin 10 mg. After 3 months on one statin, fasting lipids were measured on 10 occasions over a 5-week period. Following 3 months on the other statin, 10 further samples were taken over 5 weeks. The main outcome measures were biological variability of total cholesterol (TC), low-density lipoprotein (LDL) cholesterol, high-density lipoprotein (HDL) cholesterol and triglycerides. Results: The coefficient of variation (CV) of TC, LDL, HDL and triglycerides on simvastatin was 8.17, 13.11, 7.95 and 12.06%, respectively, whereas the CV on atorvastatin was 6.92, 10.30, 5.13 and 19.71%, respectively, with no statistically significant differences between statins. Treating to sustain a target TC < 5.0 mmol/l or LDL < 3.0 mmol/l means needing to maintain a mean TC of 4.3-4.4 mmol/l or LDL of 2.4-2.5 mmol/l. Treating to consistently achieve an LDL < 2.0 mmol/l means aiming for a mean of only 1.5-1.6 mmol/l. Conclusion: In patients with T2DM taking either simvastatin or atorvastatin, the mean TC and LDL concentrations needed to consistently remain below a target are much lower than the target value itself. This means that guideline target limits extrapolated from the mean values of patients participating in clinical studies may overestimate the lipid reductions required.

KW - Biological variation

KW - Coefficient of variation

KW - Lipids

KW - Statins

KW - Type 2 Diabetes

UR - http://www.scopus.com/inward/record.url?scp=48149112145&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=48149112145&partnerID=8YFLogxK

U2 - 10.1111/j.1464-5491.2008.02519.x

DO - 10.1111/j.1464-5491.2008.02519.x

M3 - Article

C2 - 18959603

AN - SCOPUS:48149112145

VL - 25

SP - 909

EP - 915

JO - Diabetic Medicine

JF - Diabetic Medicine

SN - 0742-3071

IS - 8

ER -