Efficacy and Safety of Metformin and Atorvastatin Combination Therapy vs. Monotherapy with Either Drug in Type 2 Diabetes Mellitus and Dyslipidemia Patients (ATOMIC): Double-Blinded Randomized Controlled Trial

被引:0
作者
Lee, Jie-Eun [1 ]
Yu, Seung Hee [2 ]
Kim, Sung Rae [3 ]
Ahn, Kyu Jeung [4 ]
Song, Kee-Ho [5 ,7 ]
Lee, In-Kyu [6 ]
Shon, Ho-Sang [6 ]
Kim, In Joo [8 ]
Lim, Soo [9 ]
Kim, Doo-Man [10 ]
Chung, Choon Hee [11 ]
Lee, Won-Young [12 ]
Lee, Soon Hee [13 ]
Kim, Dong Joon [14 ]
Cho, Sung-Rae [15 ]
Jung, Chang Hee [16 ]
Jeon, Hyun Jeong [17 ]
Lee, Seung-Hwan [18 ]
Park, Keun-Young [19 ]
Rhee, Sang Youl [20 ]
Kim, Sin Gon [21 ]
Park, Seok [22 ]
Kim, Dae Jung [23 ]
Kim, Byung Joon [24 ]
Lee, Sang Ah [25 ]
Kim, Yong-Hyun [26 ]
Kim, Kyung-Soo [27 ]
Seo, Ji A. [28 ]
Nam-Goong, Il Seong [29 ]
Lee, Chang Won [30 ]
Kim, Duk Kyu [31 ]
Kim, Sang Wook [32 ]
Cho, Chung Gu [33 ]
Kim, Jung Han [34 ]
Kim, Yeo-Joo [35 ]
Yoo, Jae-Myung [36 ]
Min, Kyung Wan [37 ]
Lee, Moon-Kyu [1 ]
机构
[1] Eulji Univ, Sch Med, Uijeongbu Eulji Med Ctr, Div Endocrinol & Metab,Dept Internal Med, 712 Dongil Ro, Uijongbu 11759, South Korea
[2] Soonchunhyang Univ, Coll Med, Dept Internal Med, Div Endocrinol & Metab,Gumi Hosp, Gumi, South Korea
[3] Catholic Univ Korea, Bucheon St Marys Hosp, Coll Med, Dept Internal Med,Div Endocrinol & Metab, Bucheon, South Korea
[4] Kyung Hee Univ, Kyung Hee Univ Hosp Gangdong, Coll Med, Dept Endocrinol & Metab, Seoul, South Korea
[5] Konkuk Univ, Dept Internal Med, Div Endocrinol & Metab, Med Ctr, Seoul, South Korea
[6] Kyungpook Natl Univ, Kyungpook Natl Univ Hosp, Dept Internal Med, Div Endocrinol & Metab,Sch Med, Daegu, South Korea
[7] Daegu Catholic Univ, Div Endocrinol & Metab, Dept Internal Med, Med Ctr, Daegu, South Korea
[8] Pusan Natl Univ Hosp, Dept Internal Med, Div Endocrinol & Metab, Busan, South Korea
[9] Seoul Natl Univ, Bundang Hosp, Dept Internal Med, Div Endocrinol & Metab,Coll Med, Seongnam, South Korea
[10] Hallym Univ, Kangnam Sacred Heart Hosp, Div Endocrinol Metab, Dept Internal Med,Coll Med, Seoul, South Korea
[11] Yonsei Univ, Wonju Severance Christian Hosp, Dept Internal Med, Div Endocrinol & Metab,Wonju Coll Med, Wonju, South Korea
[12] Sungkyunkwan Univ, Kangbuk Samsung Hosp, Dept Internal Med, Div Endocrinol & Metab,Sch Med, Seoul, South Korea
[13] Inje Univ, Dept Internal Med, Div Endocrinol & Metab, Busan Paik Hosp, Busan, South Korea
[14] Inje Univ, Ilsan Paik Hosp, Dept Internal Med, Div Endocrinol & Metab, Goyang, South Korea
[15] Changwon Fatima Hosp, Dept Internal Med, Div Endocrinol & Metab, Chang Won, South Korea
[16] Univ Ulsan, Asan Med Ctr, Dept Internal Med, Div Endocrinol & Metab,Coll Med, Seoul, South Korea
[17] Chungbuk Natl Univ, Coll Med, Div Endocrinol & Metab, Dept Internal Med,Chungbuk Natl Univ Hosp, Cheongju, South Korea
[18] Catholic Univ Korea, Seoul St Marys Hosp, Dept Internal Med, Coll Med,Div Endocrinol & Metab, Seoul, South Korea
[19] Konyang Univ Hosp, Dept Internal Med, Div Endocrinol & Metab, Daejeon, South Korea
[20] Kyung Hee Univ, Kyung Hee Univ Hosp, Coll Med, Dept Endocrinol & Metab, Seoul, South Korea
[21] Korea Univ, Coll Med, Dept Internal Med, Div Endocrinol & Metab,Anam Hosp, Seoul, South Korea
[22] Gwangmyeong Sungae Hosp, Dept Internal Med, Div Endocrinol & Metab, Gwangmyeong, South Korea
[23] Ajou Univ, Ajou Univ Hosp, Dept Internal Med, Div Endocrinol & Metab,Sch Med, Suwon, South Korea
[24] Gachon Univ, Gil Med Ctr, Dept Internal Med, Coll Med,Div Cardiol, Incheon, South Korea
[25] Jeju Natl Univ, Sch Med, Dept Internal Med, Div Endocrinol & Metab, Jeju, South Korea
[26] Bundang Jesaeng Hosp, Div Endocrinol & Metab, Dept Internal Med, Seongnam, South Korea
[27] CHA Univ, Sch Med, Dept Internal Med, Div Endocrinol & Metab,CHA Bundang Med Ctr, Seongnam, South Korea
[28] Korea Univ, Coll Med, Dept Internal Med, Div Endocrinol & Metab,Ansan Hosp, Ansan, South Korea
[29] Univ Ulsan, Div Endocrinol & Metab, Dept Internal Med, Ulsan Univ Hosp,Coll Med, Ulsan, South Korea
[30] Busan St Marys Hosp, Dept Internal Med, Div Endocrinol & Metab, Busan, South Korea
[31] Dong A Univ, Dept Internal Med, Div Endocrinol & Metab, Coll Med,Dong A Univ Hosp, Busan, South Korea
[32] Kangwon Natl Univ, Kangwon Natl Univ Hosp, Sch Med, Dept Internal Med,Div Endocrinol & Metab, Chunchon, South Korea
[33] Wonkwang Univ, Sch Med, Dept Internal Med, Div Endocrinol & Metab,Wonkwang Univ Hosp, Iksan, South Korea
[34] Sungae Hosp, Div Endocrinol & Metab, Dept Internal Med, Seoul, South Korea
[35] Soonchunhyang Univ, Coll Med, Cheonan Hosp, Div Cardiol,Dept Internal Med, Cheonan, South Korea
[36] Hallym Univ, Div Endocrinol & Metab, Dept Internal Med, Coll Med,Kangnam Sacred Heart Hosp, Seoul, South Korea
[37] Eulji Univ, Sch Med, Nowon Eulji Med Ctr, Dept Internal Med,Div Endocrinol & Metab, Seoul, South Korea
关键词
Atorvastatin; Diabetes mellitus; Dyslipidemias; Metformin; GLUCOSE-METABOLISM; LDL CHOLESTEROL; ASSOCIATION; PROFILES; STATINS;
D O I
暂无
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background: It is well known that a large number of patients with diabetes also have dyslipidemia, which significantly increases the risk of cardiovascular disease (CVD). This study aimed to evaluate the efficacy and safety of combination drugs consisting of metformin and atorvastatin, widely used as therapeutic agents for diabetes and dyslipidemia. Methods: This randomized, double-blind, placebo-controlled, parallel-group and phase III multicenter study included adults with glycosylated hemoglobin (HbA1c) levels >7.0% and <10.0%, low-density lipoprotein cholesterol (LDL-C) >100 and <250 mg/dL. One hundred eighty-five eligible subjects were randomized to the combination group (metformin+atorvastatin), metformin group (metformin+atorvastatin placebo), and atorvastatin group (atorvastatin+metformin placebo). The primary efficacy endpoints were the percent changes in HbA1c and LDL-C levels from baseline at the end of the treatment. Results: After 16 weeks of treatment compared to baseline, HbA1c showed a significant difference of 0.94% compared to the atorvastatin group in the combination group (0.35% vs. -0.58%, respectively; P < 0.0001), whereas the proportion of patients with increased HbA1c was also 62% and 15%, respectively, showing a significant difference (P< P < 0.001). The combination group also showed a significant decrease in LDL-C levels compared to the metformin group (-55.20% vs. -7.69%, P < 0.001) without previously unknown adverse drug events. Conclusion: The addition of atorvastatin to metformin improved HbA1c and LDL-C levels to a significant extent compared to metformin or atorvastatin alone in diabetes and dyslipidemia patients. This study also suggested metformin's preventive effect on the glucose-elevating potential of atorvastatin in patients with type 2 diabetes mellitus and dyslipidemia, insufficiently controlled with exercise and diet. Metformin and atorvastatin combination might be an effective treatment in reducing the CVD risk in patients with both diabetes and dyslipidemia because of its lowering effect on LDL-C and glucose.
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页码:730 / 739
页数:10
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  • [1] Efficacy and safety of fixed-dose combination therapy with gemigliptin (50 mg) and rosuvastatin compared with monotherapy in patients with type 2 diabetes and dyslipidaemia (BALANCE): A multicentre, randomized, double-blind, controlled, phase 3 trial
    Bae, Ji Cheol
    Min, Kyung Wan
    Kim, Yong Hyun
    Kim, Kyoung-Ah
    Hong, Eun-Gyoung
    Park, Cheol-Young
    Han, Song
    Cha, Bong-Soo
    [J]. DIABETES OBESITY & METABOLISM, 2019, 21 (01) : 103 - 111
  • [2] Efficacy and safety of more intensive lowering of LDL cholesterol: a meta-analysis of data from 170 000 participants in 26 randomised trials
    Baigent, C.
    Blackwell, L.
    Emberson, J.
    Holland, L. E.
    Reith, C.
    Bhala, N.
    Peto, R.
    Barnes, E. H.
    Keech, A.
    Simes, J.
    Collins, R.
    [J]. LANCET, 2010, 376 (9753) : 1670 - 1681
  • [3] Metformin and the intestine
    Bailey, C. J.
    Wilcock, C.
    Scarpello, J. H. B.
    [J]. DIABETOLOGIA, 2008, 51 (08) : 1552 - 1553
  • [4] Association of statin use and hypertriglyceridemia with diabetic macular edema in patients with type 2 diabetes and diabetic retinopathy
    Chung, Yoo-Ri
    Park, Sung Wook
    Choi, Shin-Young
    Kim, Seung Woo
    Moon, Ka Young
    Kim, Jeong Hun
    Lee, Kihwang
    [J]. CARDIOVASCULAR DIABETOLOGY, 2017, 16
  • [5] Metformin activates a duodenal Ampk-dependent pathway to lower hepatic glucose production in rats
    Duca, Frank A.
    Cote, Clemence D.
    Rasmussen, Brittany A.
    Zadeh-Tahmasebi, Melika
    Rutter, Guy A.
    Filippi, Beatrice M.
    Lam, Tony K. T.
    [J]. NATURE MEDICINE, 2015, 21 (05) : 506 - U130
  • [6] Clinical Usefulness of Different Lipid Measures for Prediction of Coronary Heart Disease in Type 2 Diabetes A report from the Swedish National Diabetes Register
    Eliasson, Bjorn
    Cederholm, Jan
    Eeg-Olofsson, Katarina
    Svensson, Anne-Marie
    Zethelius, Bjorn
    Gudbjornsdottir, Soffia
    [J]. DIABETES CARE, 2011, 34 (09) : 2095 - 2100
  • [7] Statins and glycaemic control in individuals with diabetes: a systematic review and meta-analysis
    Erqou, Sebhat
    Lee, C. Christine
    Adler, Amanda I.
    [J]. DIABETOLOGIA, 2014, 57 (12) : 2444 - 2452
  • [8] EFFECT OF METFORMIN ON POSTPRANDIAL LIPEMIA IN PATIENTS WITH FAIRLY TO POORLY CONTROLLED NIDDM
    JEPPESEN, J
    CHEN, YDI
    ZHOU, MY
    REAVEN, GM
    [J]. DIABETES CARE, 1994, 17 (10) : 1093 - 1099
  • [9] Diabetes Fact Sheets in Korea, 2020: An Appraisal of Current Status
    Jung, Chan-Hee
    Son, Jang Won
    Kang, Shinae
    Kim, Won Jun
    Kim, Hun-Sung
    Kim, Hae Soon
    Seo, Mihae
    Shin, Hye-Jung
    Lee, Seong-Su
    Jeong, Su Jin
    Cho, Yongin
    Han, Seung Jin
    Jang, Hyang Mi
    Rho, Mira
    Lee, Shinbi
    Koo, Mihyun
    Yoo, Been
    Moon, Jung-Wha
    Lee, Hye Young
    Yun, Jae-Seung
    Kim, Sun Young
    Kim, Sung Rae
    Jeong, In-Kyung
    Mok, Ji-Oh
    Yoon, Kun Ho
    [J]. DIABETES & METABOLISM JOURNAL, 2021, 45 (01) : 1 - +
  • [10] Comprehensive assessment of lipoprotein subfraction profiles according to glucose metabolism status, and association with insulin resistance in subjects with early-stage impaired glucose metabolism
    Lee, Jie-Eun
    Min, Se Hee
    Lee, Dong-Hwa
    Oh, Tae Jung
    Kim, Kyoung Min
    Moon, Jae Hoon
    Choi, Sung Hee
    Park, Kyong Soo
    Jang, Hak Chul
    Lim, Soo
    [J]. INTERNATIONAL JOURNAL OF CARDIOLOGY, 2016, 225 : 327 - 331