Background and aims: The aim of this study was to assess the effects of simvastatin (SIM), eicosapentaenoic (EPA), docosahexaenoic acid (DHA) on dynamics of such biochemical parameters in type 2 diabetic patients with cardiomyopathy (DCMP).
Materials and methods: Twenty-five patients with DM and DCMP received SIM 20 mg tid (group A); B (n=37) capsules of fish oil (Epadol: 2.0 g EPA, 2.0 g DHA and 0.1% α-tocopherol acetate), C (n=24) SIM 10 mg plus Epadol. All patients were on the same diet. We investigated the lipid profile, 125I-6-ketoprostaglandin F1α (6-ketoPGF1α), 125I-thromboxane B2 (TXB2) concentrations, liver enzymes activities in the blood plasma; Na+, K+-ATPase activities, fatty acids level in the membranes of RBCs. The duration of the study was 3 months.
Results: Lipid disorders (high level of total cholesterol (TC), LDL-C, triglycerides (TG, 7.3±10.1; 4.5±0.3; 2.87±0.2 mmol/l, P<0.05)) and decrease level of HDL-C in the patients with DCMP are accompanied by a decrease of the Na+, K+- ATPase activities in the RBCs membranes. There is a considerable increase in the TXB2 level and a decrease in serum 6-ketoPGF1α, EPA, DHA levels in the RBCs membranes. It has been discovered that the monotherapy by SIM is accompanied by negative dynamics of liver enzymes activity. After 3 months of treatment there was a more significant decrease in LDL-C, TC, TG concentration, TXB2 level (152.5±16.9 pg/ml, P<0.001) with simultaneous increases of EPA level, EPA/arachidonic acid ratio, Na+, K+-ATPase (0.04±0.003 vs 0.09±0.004 mmol Pi/mg protein per 1 h, P<0.001) and the concentration of 6-ketoPGF1α in the 3rd group (P<0.001).
Conclusion: The combined purpose SIM and Epadol significantly improve the lipid profile, state of prostacyclin I2-thromboxane A2 system, lower a doze SIM, that allows to recommend their combination in the rational-proved treatment of patients with DCMP.