Combined effects of atorvastatin and metformin on glucose-induced variations of inflammatory process in patients with diabetes mellitus

Abstract Background Statin treatment improves survival in patients with atherosclerosis, but their effect on the glucose-induced variations of inflammatory markers, is unknown. We examined the effect of combined therapy with atorvastatin and metformin on glucose-induced variations of inflammatory molecules in patients with newly diagnosed diabetes mellitus type 2 (DM). Methods Thirty five subjects with newly diagnosed DM were randomized to receive metformin 850 mg/d (M, n = 17) or metformin 850 mg/d + atorvastatin 10 mg ( n = 18). All subjects underwent glucose loading (75 g oral glucose) at baseline and after 12 weeks of treatment. Blood samples were obtained at baseline and 3 h post-loading, while serum tumor necrosis factor alpha (TNF-α) levels were determined at baseline and at 3 h. Results Serum TNF-α remained unchanged in metformin at baseline (1.36 ± 0.18 to 1.47 ± 0.21 pg/ml p = NS) and after treatment (1.44 ± 0.71 to 1.31 ± 0.17 pg/ml, p = NS), while it was reduced in metformin + atorvastatin (2.3 ± 0.3 to 2.0 ± 0.4 pg/ml, p = NS at baseline and 1.80 ± 0.2 to 1.65 ± 0.2 pg/ml, p = 0.03 after treatment). Conclusions Interestingly, the combination of metformin and atorvastatin partly prevents the glucose-loading induced elevation of glucose levels (at 1 h), suggesting a better response to glucose intake than monotherapy with metformin. In addition, combined treatment with atorvastatin and metformin reduces the post-glucose loading levels of TNF-α compared to metformin monotherapy.