Mechanisms
Statin-induced LDL and non-HDL cholesterol reductions track with falling CETP mass in type 2 diabetes (Expert Opin Ther Targets 2009)
Original title: Atorvastatin affects low density lipoprotein and non-high density lipoprotein cholesterol relations with apolipoprotein B in type 2 diabetes mellitus: modification by triglycerides and cholesteryl ester transfer protein
This study examined how atorvastatin affects the relationship of LDL cholesterol and non-HDL cholesterol with apolipoprotein B (apoB) in 217 hypertriglyceridaemic type 2 diabetic patients from the DALI cohort, randomized to placebo or atorvastatin 10 or 80 mg daily. During atorvastatin treatment, lower LDL cholesterol (2.38 and 2.29 mmol/l at 10 and 80 mg) and non-HDL cholesterol (3.24 and 3.19 mmol/l) most frequently corresponded to the apoB guideline target of 0.90 g/l, and the LDL-C target was achieved most often. Decreases in LDL-C were negatively related to changes in triglycerides while decreases in non-HDL-C were positively related to them (both p less than 0.001), independent of apoB changes. Critically, decreases in LDL-C and non-HDL-C during atorvastatin treatment were positively associated with decreases in cholesteryl ester transfer protein mass (p less than 0.001), suggesting statin-induced reductions in CETP contribute to the lipid changes observed and supporting apoB as a treatment target.
Original abstract
Objectives: Non-HDL-cholesterol (non-HDL-C) and apolipoprotein (apo) B are proposed as treatment targets. The extent to which statin therapy affects relationships of LDL-C and non-HDL-C with apoB was examined in type 2 diabetes.
Methods: Analyses were performed in 217 hypertriglyceridaemic type 2 diabetic patients (Diabetes Atorvastatin Lipid Intervention (DALI) cohort). 61 patients randomized to placebo, 70 to 10 mg atorvastatin daily and 65 - 80 mg atorvastin daily completed follow-up.
Results: Baseline fasting LDL-C of 2.42 mmol/l and non-HDL-C of 3.69 mmol/l corresponded to the apoB guideline target of 0.90 g/l. During atorvastatin (10 and 80 mg daily), the LDL-C target was achieved most frequently, and lower LDL-C (2.38 and 2.29 mmol/l) and non-HDL-C (3.24 and 3.19 mmol/l) concentrations corresponded to this apoB goal. Decreases in LDL-C during atorvastatin treatment were negatively related (p < 0.001), but decreases in non-HDL-C were positively related to changes in triglycerides (p < 0.001), independently from decreases in apoB (p < 0.001 for all). Decreases in LDL-C and non-HDL-C were positively associated with decreases in cholesteryl ester transfer protein mass (p < 0.001).
Conclusions: During atorvastatin lower LDL-C and non-HDL-C levels correspond to the apoB guideline target, which would favour its use as treatment target.
Summary written by cetpinhibition.org from the published abstract; figures as published. Page updated 18 August 2026. Methods.