Targets of statin therapy: LDL cholesterol, non-HDL cholesterol, and apolipoprotein B in type 2 diabetes in the collaborative atorvastatin diabetes study (CARDS)Citation formats
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Targets of statin therapy: LDL cholesterol, non-HDL cholesterol, and apolipoprotein B in type 2 diabetes in the collaborative atorvastatin diabetes study (CARDS). / Charlton-Menys, Valentine; Betteridge, D. John; Colhoun, Helen; Fuller, John; France, Michael; Hitman, Graham A.; Livingstone, Shona J.; Neil, H. Andrew W; Newman, Connie B.; Szarek, Michael; DeMicco, David A.; Durrington, Paul N.
In: Clinical Chemistry, Vol. 55, No. 3, 01.03.2009, p. 473-480.Research output: Contribution to journal › Article › peer-review
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T1 - Targets of statin therapy: LDL cholesterol, non-HDL cholesterol, and apolipoprotein B in type 2 diabetes in the collaborative atorvastatin diabetes study (CARDS)
AU - Charlton-Menys, Valentine
AU - Betteridge, D. John
AU - Colhoun, Helen
AU - Fuller, John
AU - France, Michael
AU - Hitman, Graham A.
AU - Livingstone, Shona J.
AU - Neil, H. Andrew W
AU - Newman, Connie B.
AU - Szarek, Michael
AU - DeMicco, David A.
AU - Durrington, Paul N.
PY - 2009/3/1
Y1 - 2009/3/1
N2 - LDL can vary considerably in its cholesterol content; thus, lowering LDL cholesterol (LDLC) as a goal of statin treatment implies the existence of considerable variation in the extent to which statin treatment removes circulating LDL particles. This consideration is particularly applicable in diabetes mellitus, in which LDL is frequently depleted of cholesterol. methods: Type 2 diabetes patients randomly allocated to 10 mg/day atorvastatin (n = 1154) or to placebo (n = 1196) for 1 year were studied to compare spontaneous and statin-induced apolipoprotein B (apo B) concentrations (a measure of LDL particle concentration) at LDLC and non-HDL cholesterol (non-HDLC) concentrations proposed as statin targets in type 2 diabetes. results: Patients treated with atorvastatin produced lower serum apo B concentrations at any given LDLC concentration than patients on placebo. An LDLC concentration of 1.8 mmol/L (70 mg/dL) during atorvastatin treatment was equivalent to a non-HDLC concentration of 2.59 mmol/L (100 mg/dL) or an apo B concentration of 0.8 g/L. At the more conservative LDLC targets of 2.59 mmol/L (100 mg/dL) and 3.37 mmol/L (130 mg/dL) for non-HDLC, however, the apo B concentration exceeded the 0.9-g/L value anticipated in the recent Consensus Statement from the American Diabetes Association and the American College of Cardiology. CONCLUSIONS: The apo B concentration provides a more consistent goal for statin treatment than the LDLC or non-HDLC concentration. © 2008 American Association for Clinical Chemistry.
AB - LDL can vary considerably in its cholesterol content; thus, lowering LDL cholesterol (LDLC) as a goal of statin treatment implies the existence of considerable variation in the extent to which statin treatment removes circulating LDL particles. This consideration is particularly applicable in diabetes mellitus, in which LDL is frequently depleted of cholesterol. methods: Type 2 diabetes patients randomly allocated to 10 mg/day atorvastatin (n = 1154) or to placebo (n = 1196) for 1 year were studied to compare spontaneous and statin-induced apolipoprotein B (apo B) concentrations (a measure of LDL particle concentration) at LDLC and non-HDL cholesterol (non-HDLC) concentrations proposed as statin targets in type 2 diabetes. results: Patients treated with atorvastatin produced lower serum apo B concentrations at any given LDLC concentration than patients on placebo. An LDLC concentration of 1.8 mmol/L (70 mg/dL) during atorvastatin treatment was equivalent to a non-HDLC concentration of 2.59 mmol/L (100 mg/dL) or an apo B concentration of 0.8 g/L. At the more conservative LDLC targets of 2.59 mmol/L (100 mg/dL) and 3.37 mmol/L (130 mg/dL) for non-HDLC, however, the apo B concentration exceeded the 0.9-g/L value anticipated in the recent Consensus Statement from the American Diabetes Association and the American College of Cardiology. CONCLUSIONS: The apo B concentration provides a more consistent goal for statin treatment than the LDLC or non-HDLC concentration. © 2008 American Association for Clinical Chemistry.
KW - Adult
KW - Aged
KW - blood: Apolipoproteins B
KW - blood: Cholesterol, HDL
KW - blood: Cholesterol, LDL
KW - blood: Diabetes Mellitus, Type 2
KW - Female
KW - therapeutic use: Heptanoic Acids
KW - Humans
KW - metabolism: Hydroxymethylglutaryl CoA Reductases
KW - therapeutic use: Hydroxymethylglutaryl-CoA Reductase Inhibitors
KW - Male
KW - Middle Aged
KW - therapeutic use: Pyrroles
U2 - 10.1373/clinchem.2008.111401
DO - 10.1373/clinchem.2008.111401
M3 - Article
VL - 55
SP - 473
EP - 480
JO - Clinical Chemistry
JF - Clinical Chemistry
SN - 0009-9147
IS - 3
ER -