Lifestyle intervention and/or statins for the reduction of C-reactive protein in type 2 diabetes: From the look AHEAD study

Objective: Cardiovascular risk remains high despite statin use. Overweight/obese diabetic persons usually have normal/low LDL-cholesterol but high C-reactive protein (CRP) levels. We aimed to examine the effects of intensive lifestyle intervention for weight loss (ILI) on CRP levels in overweight/obese diabetic individuals by statin use. Design and Methods: Look AHEAD was a randomized trial in overweight/obese type 2 diabetic individuals testing whether ILI would reduce cardiovascular mortality, when compared to usual care. CRP changes in 1,431 participants with biomarker levels, who remained on or off statin treatment for 1 year, were evaluated. Results: The reduction in CRP levels with ILI at 1 year in men and women on statins was -44.9 and -42.3%, respectively, compared to -13.7 and -21.0% for those on statins and usual care (P < 0.0001). At 1 year, median CRP levels were: 1.8 mg L ^-1 in participants randomized to ILI on statin therapy; 2.6 mg L ^-1 for those on statins randomized to usual care and 2.9 mg L ^-1 for participants not on statins but randomized to ILI. Weight loss was associated with 1-year CRP reduction (P < 0.0001) in statin and nonstatin users. Conclusions: Our findings suggest that in overweight/obese diabetic persons, ILI and statin therapy may have substantial additive anti-inflammatory benefits.