Abstract 14666: Intensive Lifestyle Intervention Further Reduces High-Sensitivity C-Reactive Protein in Statin Users, Findings From the Look Ahead (Action for Health in Diabetes) Study
Background: Both statin therapy and intensive lifestyle intervention have been shown to decrease high sensitivity C-reactive protein (hs-CRP), however it is unclear if lifestyle intervention has similar benefits in patients already on statins. Look AHEAD is a multicenter clinical trial designed to examine whether an intensive lifestyle intervention for weight loss (ILI) will reduce cardiovascular (CV) events in overweight/obese persons with type 2 diabetes (T2DM).
Objective: To determine if ILI decreases hs-CRP levels at one year in obese men and women with T2DM who are already on statin therapy.
Methods: We evaluated a subset of 1,759 Look AHEAD participants randomized to either ILI or usual care (Diabetes Support and Education, DSE) who had complete data for hs-CRP and fitness (exercise stress test) at baseline and one year. The effect of statins on hs-CRP change after one year of ILI was evaluated by including an interaction between statin therapy and randomization arm within a multivariate regression model adjusted for demographics; changes in BMI, HbA1c, fitness and HDL; thiazolidinedione use, smoking and CV disease. Differences in 1-year change of median (interquartile range [IQR]) hs-CRP between ILI and DSE were also tested after stratifying by gender and statin use.
Results: Participants (age 57.5 ±7.1 years, BMI 36.3 ± 6.3 kg/m2, HbA1c 7.3 ± 1.2 % and fitness level 5.2± 1.5 METS on submaximal effort) had a baseline hs-CRP level of 4.2 (1.9, 8.9) mg/L. ILI showed a greater decrease in hs-CRP levels in both men and women regardless of statin use when compared to DSE (Table). Test for interaction with the intervention (randomization arm*statin use) in the multivariate model was not significant (p=0.43).
Conclusion: ILI significantly decreased hs-CRP levels in obese men and women with T2DM regardless of statin use, suggesting that efforts to improve lifestyle behaviors may be beneficial in patients who are taking statins and still have elevated levels of hs-CRP.
- © 2010 by American Heart Association, Inc.