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Lipid-Lowering Effect of Extra Virgin Olive Oil and Atorvastatin in Type 2 Diabetes

Extra virgin olive oil, like statins, promotes lipid lowering in people with diabetes who have dyslipidemia.

Diabetes mellitus is a worldwide metabolic disorder that is caused by insulin deficiency. It often causes abnormalities in carbohydrate, lipid, and protein metabolism. Dyslipidemia consists of elevated triglycerides, total cholesterol, low-density lipoprotein (LDL), and a decreased level of high-density lipoproteins (HDL). This alteration in lipid levels can lead to various microvascular diseases such as retinopathy and neuropathy. Individuals diagnosed with dyslipidemia often have serum cholesterol levels greater than 200mg/dL, serum triglycerides greater than 200mg/dL, LDL levels greater than 130 mg/dL, and HDL levels <40mg/dL in men and <50mg/dL in women. An increase in LDL levels can increase the risk of coronary heart disease whereas an increase in HDL levels lowers this risk.

HMG-CoA reductase inhibitors known as statins are hypolipidemic drugs that lower lipid levels in patients with mixed hyperlipidemia. One of the most commonly used statins to treat dyslipidemia is atorvastatin. Like most statins, atorvastatin is used at bedtime due to its ability to have maximum efficacy in treating increased cholesterol synthesis that takes place at midnight. As with most medications, statins exhibit some adverse side effects like liver damage and muscle pain. Other hypolipidemic agents like extra virgin olive oil (EVOO) also aim to lower total cholesterol levels, LDL, and serum triglycerides, as well as increase HDL levels. EVOO is retrieved from the cold pressing of olives without the use of chemical solvents. This natural product is a rich source of monosaturated fats and antioxidants, which help reduce clogging of arteries.

In the study titled “Comparison of Lipid Lowering Effect of Extra Virgin Olive Oil and Atorvastatin in Dyslipidemia in Type 2 Diabetes Mellitus,” researchers aimed to observe the effects of EVOO on lipid lowering in diabetes patients with dyslipidemia. A randomized control trial was performed over a six-week period. Sixty subjects previously diagnosed with type 2 diabetes mellitus and dyslipidemia were studied. Of the sixty subjects, 26 were male and 34 were female. The subjects were age 40 years or older and divided into two groups. Individuals who had kidney disease, ischemic heart disease, stroke or peripheral vascular disease were excluded from the study. In addition, pregnant and lactating women were also excluded from the study. In one group, atorvastatin was given as a dose of 40mg once daily by mouth at bedtime for six weeks. In the second group, participants were given two tablespoons of EVOO once daily for six weeks. Both products were given to diabetes patients regardless of any oral antidiabetics used in conjunction. At four and six weeks of the study, blood samples were taken before breakfast after a 12-hour fast. The remaining clotted blood sample was used to analyze the lipid profile.

Results showed that mean differences of plasma total cholesterol, serum triglycerides, LDL, and HDL levels were found to be 110.14, 103.9, 67.43, and 3.899 respectively. In the patients using EVOO, the values were 43.00, 45.9667, 30.65 and 3.44 for plasma total cholesterol, serum triglycerides, LDL, and HDL levels. When measuring plasma total cholesterol, triglycerides, and LDL levels, p value was <0.05 and was higher in HDL levels (p=0.122). These results showed that total cholesterol, triglycerides and LDL cholesterol were reduced by 20-40% while patients using EVOO showed a reduction of 14-25%. Moreover, HDL levels were increased by 9-16% in the group of patients receiving atorvastatin and by 8-12% in patients taking EVOO.

Researchers concluded that it is apparent that atorvastatin reduced total cholesterol, triglycerides, and LDL levels greater when compared with EVOO. However, the side effects of statins in promoting muscle and liver damage pose a risk to individuals despite its substantial effects in treating dyslipidemia. EVOO contains polyphenols, which are powerful antioxidants that promote good health and prevent lipid build-up in blood vessels, which could clog arteries. In addition to this, EVOO also has vasodilatory, antihypertensive, antithrombotic and anti-inflammatory effects. Moreover, according to past studies, consuming at least 2 tablespoons of olive oil a day can result in a substantial decline in plasma lipids and an increase in HDL levels.

Practice Pearls:

  • Dyslipidemia is a disease often accompanied by diabetes mellitus.
  • Statins are generally used for the treatment of dyslipidemia.
  • Recent studies have shown that the use of EVOO may contribute to lipid lowering by lowering LDL, triglycerides and total cholesterol, as well as, increasing HDL levels.

Khan, Tariq Mahmood, Sohail Iqbal, and Muhammad Adnan Rashid. “COMPARISON OF LIPID LOWERING EFFECT OF EXTRA VIRGIN OLIVE OIL AND ATORVASTATIN IN DYSLIPIDEMIA IN TYPE 2 DIABETES MELLITUS.” Journal of Ayub Medical College Abbottabad. N.p., n.d. Web. 19 July 2017.

 

Nuha Awad, Doctor of Pharmacy Candidate: Class of 2018; LECOM College of Pharmacy