ABSTRACT
OBJECTIVE: The aim of this study was to investigate the effects of omega-3 fatty acids added to statin monotherapy in Korean patients with type 2 diabetes who have persistent hypertriglyceridemia despite statin therapy. METHODS: This study was a randomized controlled trial conducted in 4 clinical sites between February 2009 and February 2011. The inclusion criteria were patients with type 2 diabetes who had received ≥6 weeks of statin therapy and had fasting triglyceride (TG) levels ≥1.7mmol/L and low-density lipoprotein (LDL) cholesterol levels <2.6 mmol/L. The study regimen consisted of 16 weeks of randomized treatment with omega-3 fatty acids (4 g/day) plus a statin (n=26) or statin only (n=30). The primary endpoint was the change from baseline to final visit in mean TG level. RESULTS: A total of 56 participants were analyzed. At week 16, the change in the TG level in the combination therapy group differed significantly from the change in the statin monotherapy group (-34.8% vs. -15.2%, p=0.0176). Treatment with omega-3 fatty acids plus a statin was also associated with a significant decrease in non-high-density lipoprotein cholesterol compared with baseline, but the difference was not significant compared with the statin monotherapy group (-8.0% vs. -2.5%, p=0.165). The changes in LDL cholesterol and HbA1c levels did not differ significantly between groups. The study medications were well tolerated, and adverse events were comparable between two groups. CONCLUSION: Adding omega-3 fatty acids to statin treatment reduced TG levels more effectively than statin monotherapy without undesirable effects in Korean type 2 diabetic patients who had hypertriglyceridemia despite well-controlled LDL cholesterol on stable statin therapy. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT02305355.
ABSTRACT
CONTEXT: Vascular endothelial growth factor (VEGF) is a potent angiogenic and vascular permeability factor, and its polymorphisms are associated with proliferative diabetic retinopathy (PDR) and macular edema. OBJECTIVE: We investigated the contributions of VEGF gene polymorphisms to nonproliferative diabetic retinopathy (NPDR) as well as PDR. DESIGN, SETTING, AND SUBJECTS: In this study we compared VEGF gene variants in a sample of Korean type 2 diabetes patients with and without diabetic retinopathy (DR) and in healthy controls. Of the diabetes patients, 145 had PDR, 108 had NPDR, and 134 had no retinopathy (noDR). They were all duration matched. Samples were genotyped for rs699947, rs1570360, and rs2010963 polymorphisms. RESULTS: We found a significant association between the A allele at rs699947 with DR (odds ratio = 1.84 (95% confidence interval = 1.28-2.66); P = 0.001 vs. noDR). Patients with NPDR, as well as PDR, had increased incidence of the A allele. The AGG haplotype was more frequently found in patients with DR than in patients with noDR (odds ratio = 4.79 (95% confidence interval = 1.42-16.16); P = 0.006). PDR and NPDR patients exhibited an increased incidence of the AGG haplotype. CONCLUSIONS: VEGF polymorphisms might be a useful predictive marker for the development and progression of DR at an earlier stage of diabetes.
