Early vascular and metabolic effects of rosuvastatin compared with simvastatin in patients with type 2 diabetes

Objective: To compare the short-term effects of rosuvastatin and simvastatin on insulin-resistance and endothelial dysfunction in middle-aged patients with type 2 diabetes and mild untreated dyslipidemia. Methods and design: 29 subjects randomly assigned to rosuvastatin 20 mg/daily or simvastatin 20 mg/daily for 4 weeks. Following data collected both pre- and post- treatment: fasting glucose, lipids, hs CRP, TNF-alpha, insulin sensitivity measured with euglycemic-hyperinsulinemic clamp and flowmediated dilation with brachial artery reactivity technique. Results: Both treatments markedly reduced LDL cholesterol (p<0.001 for both). Insulin sensitivity did not change from relative baseline values in both groups, as well as fasting glucose and adiponectin. Simvastatin significantly improved flow-mediated dilation (p<0.01), to a greater extent than in patients taking rosuvastatin (p=0.09). We found no association between flow-mediated dilation improvement, LDL reduction and changes in hs CRP levels. Conclusion: In type 2 diabetic individuals rosuvastatin was less effective than simvastatin at improving endothelium-dependent vasodilation within one month, without affecting insulin-resistance, adiponectin levels and inflammation.