Comparison of efficiency of omega-3 polyunsaturated fatty acids, statins and their combination on lipids parameters, vascular-thrombocyte homeostasis and heart rate variability parameters in patients with type 2 diabetes mellitus and cardiovascular autono

• Main Authors: V.A. Serhiyenko, S. Azhmi, A.A. Serhiyenko
• Format: Article
• Language: English
• Published: Publishing House Zaslavsky 2017-08-01
• Series: Mìžnarodnij Endokrinologìčnij Žurnal
• Subjects: type 2 diabetes mellitus; cardiovascular autonomic neuropathy; lipids; endothelin-1; prostacyclin I2 thromboxane A2 system; heart rate variability; ω-3 polyunsaturated fatty acids; statins; combined therapy
• Online Access: http://iej.zaslavsky.com.ua/article/view/110020

Background. The analysis of combined omega-3 polyunsaturated fatty acids (w-3 PUFAs) and statins prescription to patients with cardiac autonomic neuropathy (CAN) and type 2 diabetes mellitus (T2DM) is of great interest. However existing data about features of their prescription are fragmentary, under discussion and thus require further investigation. Purpose of the study was to compare the influence of w-3 PUFAs, statins and their combination on lipids parameters, vascular-thrombocyte homeostasis and heart rate variability (HRV) parameters in patients with T2DM and CAN. Materials and methods. The study involved 75 patients with T2DM and functional stage of CAN. The concentration of glucose, HbA1c, total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), endothelin-1 (ET-1), thromboxane B2 (TXB2), 6-ketoprostoglandine F1a (6-ketoPGF1a) in the blood were determined; atherogenic coefficient (AC) and TXB2/6-ketoPGF1a were calculated. Short time HRV was analyzed using time and spectral parameters. Patients with T2DM and functional stage of CAN were divided into four groups: patients in the 1st group (n = 21) received one capsule/day of w-3 PUFAs in addition to standard treatment; patients in the 2nd group (n = 22) received simvastatin 20 mg/daily; patients of the 3rd group (n = 17) received one capsule of w-3 PUFAs and simvastatin 10 mg/daily; patients of the 4rd group (n = 22) took standard glucose lowering therapy (control group). The study lasted 3 months. Results. Administration of w-3 PUFAs to patients with T2DM and CAN promoted to the statistically significant decrease in TG, AC and increase of HDL-C, but no significant changes of TC and LDL-C was found. Prescription of simvastatin was accompanied by statistically significant decrease in TC, LDL-C, AC, ТХВ2, TXB2/6-ketoPGF1a and increase in HDL-C, ЕТ-1, 6-ketoPGF1a levels; time-domain and spectral parameters of HRV. Combined administration of w-3 PUFAs and simvastatin promoted to the most statistically significant positive changes of lipid profile, endothelial function, ТХВ2,TXB2/6-ketoPGF1a levels, time-domain and spectral parameters of HRV. Conclusions. Obtained results demonstrated that effects of combined simvastatin and omega-3 PUFAs prescription are not connected with diabetes mellitus compensation state and are the results of an direct influence of this pharmacological agents on investigated parameters, that justify the appropriateness of their prescription to patients with T2DM and functional stage of CAN.