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Effects of atorvastatin and vitamin C on forearm hyperaemic blood flow, asymmentrical dimethylarginine levels and the inflammatory process in patients with type 2 diabetes mellitus
  1. Dimitris Tousoulis,
  2. Charalambos Antoniades,
  3. Carmen Vasiliadou,
  4. Pantelis Kourtellaris,
  5. Katerina Koniari,
  6. Kyriakoula Marinou,
  7. Marietta Charakida,
  8. Ioannis Ntarladimas,
  9. Gerasimos Siasos,
  10. Christodoulos Stefanadis
  1. Athens University Medical School, A′ Cardiology Department, Hippokration Hospital, Athens, Greece
  1. Correspondence to:
    Dr Dimitris Tousoulis
    Athens University Medical School, A′ Cardiology Department, Vasilissis Sofias 114, 11528, Athens, Greece; drtousoulis{at}

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Type 2 diabetes mellitus (DM) is characterised by increased oxidative stress as a result of the hyperglycaemic state, leading to decreased nitric oxide bioavailability.1 Similarly, type 2 DM is characterised by increased levels of proatherogenic cytokines and adhesion molecules,1 while it has been shown that the endogenous endothelial nitric oxide synthase inhibitor, asymmetrical dimethyl arginine (ADMA), is also elevated in type 2 DM.2 Although ADMA synthesis is triggered by both oxidative stress and proinflammatory stimuli, the effect of antioxidant or anti-inflammatory treatment on its release is unclear.

We compared the effects of atorvastatin (which has anti-inflammatory properties in atherosclerosis) and vitamin C (a well-known antioxidant) on the inflammatory process, endothelial function and the release of ADMA in normocholesterolaemic patients with type 2 DM.


Forty-one patients with type 2 DM and no evidence of macroangiopathy were recruited (table 1). The absence of coronary artery disease (CAD) was established by a negative exercise stress test within the last 6 months before recruitment, while peripheral artery disease was defined as an ankle brachial index <0.90. All patients had cholesterol <5.4 mmol/l at baseline, and exclusion criteria were the use of statins, insulin, antioxidant supplements, hormone replacement therapy or anti-inflammatory medication during the past year, or the presence of any chronic disease or infection. All subjects had normal renal function (normal creatinine clearance as calculated by the Cockroft-Gault formula and no macroalbuminuria). Patients were randomly allocated into groups receiving atorvastatin (10 mg/day), vitamin C (2 g/day) or no …

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  • Competing interests: None declared.

  • Published Online First 16 August 2006