Effect of atorvastatin on lipogenic, inflammatory and thrombogenic markers in women with the metabolic syndrome

• Published in: Nutrition, metabolism, and cardiovascular diseases metabolism, and cardiovascular diseases, 2021-02, Vol.31 (2), p.634-640
• Main Authors: Velarde, Gladys P., Choudhary, Naila, Bravo-Jaimes, Katia, Smotherman, Carmen, Sherazi, Saadia, Kraemer, Dale F.
• Format: Article
• Language: English
• Subjects: Adult; Atorvastatin - therapeutic use; Biomarkers; Biomarkers - blood; Blood Coagulation - drug effects; Blood Platelets - drug effects; Blood Platelets - metabolism; Double-Blind Method; Female; Humans; Hydroxymethylglutaryl-CoA Reductase Inhibitors - therapeutic use; Inflammation Mediators - blood; Lipids - blood; Metabolic syndrome; Metabolic Syndrome - blood; Metabolic Syndrome - diagnosis; Metabolic Syndrome - drug therapy; Middle Aged; Platelet Activation - drug effects; Prospective Studies; Randomized trial; Statins; Time Factors; Treatment Outcome
• ISSN: 0939-4753; 1590-3729
• DOI: 10.1016/j.numecd.2020.10.002

Specific drug therapy to target the underlying proinflammatory and prothrombotic state in patients with metabolic syndrome (MS) is lacking. We sought to study the effect of high-intensity atorvastatin on markers of lipogenesis, inflammation and thrombogenesis, in women with MS in the absence of cardiovascular disease or diabetes. This randomized double-blinded controlled trial included 88 women with MS (according to National Cholesterol Education Panel Adult Treatment Panel III criteria) and low atherosclerotic cardiovascular risk. Participants were randomized to receive atorvastatin 80 mg or matching placebo. Thrombogenic, lipogenic and inflammatory markers were collected at the time of enrollment, after a 6-week dietary run-in phase (time of randomization), and at 6- and 12-weeks after randomization. At 6 weeks post-randomization, there was significant reduction in total cholesterol, low density lipoprotein cholesterol, triglycerides, apolipoprotein-B (Apo-B) and Apo-B/Apo-A1 ratio in the atorvastatin arm compared to placebo. This difference persisted at 12-weeks post randomization. There was no significant difference in fasting blood glucose, high-density lipoprotein cholesterol, high sensitivity C-reactive protein, serum leptin, Apo-A1, intercellular adhesion molecule 1 and platelet activity. A significant increase in vascular adhesion molecule 1 at 6 and 12 weeks was seen within the atorvastatin arm. No difference was observed in blood pressure and waist circumference. In conclusion, high-intensity atorvastatin has an early and significant impact on lipoproteins and apolipoproteins but did not lower inflammatory, thrombogenic or biomarkers of platelet activity and aggregation in women with MS. The use of statins for primary prevention in these patients should be further explored. •Therapies targeting pro-inflammatory/thrombotic state in metabolic syndrome (MS) are lacking.•We randomized women with MS to high-intensity atorvastatin or placebo and assessed biomarkers.•Total cholesterol, LDL, triglycerides, Apo-B and Apo-B/Apo-A1 decreased in the atorvastatin arm.•Blood glucose, HDL, hs-CRP, leptin, Apo-A1, ICAM-1 and platelet activity remained unchanged.•The use of statins for primary prevention in MS patients should be further explored.