Effect of COX-2 Inhibitors Selectivity on Lipid Profile in Hyperlipidemic and Normolipidemic Type 2 Diabetics

Abstract

Development of NSAIDS based on inhibiting cyclooxygenase activity. However, the different physiological consequences arrised by appearance of new drugs with different selectivity to COX-2 enzyme upon their administration with their relevant affects on some cardiovascular risk factors. To study the potential effects of relatively  diclofenac and highly specific  celecoxib COX-2 inhibitors on lipid profile and serum C-reactive protein in type 2 diabetes, whom have hyperlipidemia to be compared by their effects with normolipidemic patients. A total number of 34 type 2 diabetics (14 normolipidemics and 20 hyperlipidemics) treated with either diclofenac 100mg/day or celecoxib 200mg/day for eight weeks. Analysis  of results indicated that diclofenac increased serum triglycerides (TG) whereas; celecoxib group exerted a significant reduction in total cholesterol (TC), triglycerides (TG) levels in hyperlipidemic patients. Normolipidemic diabetics showed a significant elevation in serum total cholesterol, triglycerides and low density lipoprotein-cholesterol (LDL) with significant reduction in high density lipoprotein-cholesterol (HDL) in those treated with diclofenac , whilst those treated with celecoxib exhibited no modification of serum lipids. The results of the present study indicated that the net effect of treatment of hyperlipidemic type 2 diabetics by diclofenac was mostly qualitative as indicated by elevated TG/HDL ratio, to be a marker of atherogenic- small dense LDL particles in diabetics, whereas celecoxib exerted no such effect in this group but produced a beneficial reduction in LDL/HDL ratio. Meanwhile, diclofenac in  normolipidemic diabetics exert a significant qualitative and quantitative modulation of their serum lipid components presented by net elevation in both LDL/HDL and TG/HDL ratios.  As a conclusion the administration of relatively selective COX-2 inhibitors ( diclofenac ) to normolipidemic type 2 diabetics could adversely affect lipid metabolism by producing undesirable qualitative as well as , quantitative changes in serum lipid components, more than that observed in the hyperlipidemic diabetics.  Key Words: Diabetes, lipid profile, cox-2 selectivity