Effectiveness of atorvastatin application in patients with chronic obstructive lung disease with concomitant diabetes type 2

Abstract

The aim of the study was to study the efficacy of using atorvastatin in patients with chronic obstructive pulmonary disease (COPD) with concomitant type 2 diabetes mellitus (DM). Material and methods. 49 COPD patients with concomitant type 2 diabetes were examined. Patients were prescribed atorvastatin 20-40 mg once daily for 6 months in addition to standard therapy. In the examination of patients used the CAT-test, the test with a 6-minute walk, the integral BODE index, spirometry, bio-impedance analysis. The dynamics of treatment also evaluated the lipid spectrum of the blood, carbohydrate metabolism, functional state of the endothelium, the level of leptin, adiponectin, resistin, tumor necrosis factor-α (TNFα), transforming growth factor-β1 (TGFβ1) and C-reactive protein (SRB) blood. Results. In the analysis of bioimpedansometry indicators in the dynamics of atorvastatin treatment in patients with COPD with concomitant type 2 diabetes, a significant decrease in the percentage of fat, visceral fat and BMI was found. When evaluating spirometry, there was a tendency for an increase in FEV1, but no confidence (p> 0.05). Six months of atorvastatin treatment in COPD patients with concomitant diabetes mellitus type 2 showed a significant decrease in shortness of breath by 61.8% (p> 0.05), a decrease in the SAT score by 40.7% (p 0.05). The levels of adipocytokines (leptin and resistin), TNFα, TGFβ1, and CRP in serum when using atorvastatin in COPD patients with concomitant type 2 diabetes significantly decreased in the absence of significant changes in adiponectin (p> 0.05). Analysis of endothelial functional status indicators at the end of treatment showed a probable 35.3% increase in nitrate / nitrite level, a 2-fold decrease in CCEE (p <0.001), and a 2.3-fold increase in ET-1 (p <0.001). According to the study, atorvastatin had no significant effect on carbohydrate metabolism, but did improve blood lipid spectrum. Therefore, in patients with COPD with concomitant type 2 diabetes, the use of atorvastatin does not impair the course of diabetes, but may possibly reduce cardiovascular risk by improving carbohydrate metabolism. Given that statins improve the functional state of the endothelium, the effect of atorvastatin on endothelial dysfunction in patients with COPD with concomitant type 2 diabetes has been investigated. Conclusions. Thus, the six-month application of atorvastatin in the complex treatment of patients with COPD with concomitant type 2 diabetes improves body composition, exercise tolerance, quality of life, prognosis and reduces the severity of comorbid pathology against the backdrop of manifestations of systemic inflammation.