Atorvastatin linked to insulin resistance and increased glycated hemoglobin

January 01, 0001

Atorvastatin linked to insulin resistance and increased glycated hemoglobin

Clinical trials suggest that some statin treatments might increase the incidence of diabetes despite reductions in low-density lipoprotein (LDL) cholesterol and improvement in endothelial dysfunction. The researchers from Korea and USA investigated whether atorvastatin might decrease insulin sensitivity and increase ambient glycemia in hypercholesterolemic patients. A randomized, single-blind, placebo-controlled parallel study was conducted in 44 patients taking placebo and in 42, 44, 43, and 40 patients given daily atorvastatin 10, 20, 40, and 80 mg, respectively, during a 2- month treatment period.

Atorvastatin 10, 20, 40, and 80 mg significantly reduced LDL cholesterol (39%, 47%, 52%, and 56%, respectively) and apolipoprotein B levels (33%, 37%, 42%, and 46%, respectively) after 2 months of therapy when compared with either baseline or placebo. Atorvastatin 10, 20, 40, and 80 mg significantly increased fasting plasma insulin (mean changes: 25%, 42%, 31%, and 45%, respectively) and glycated hemoglobin levels (2%, 5%, 5%, and 5%, respectively) when compared with either baseline or placebo. Atorvastatin 10, 20, 40, and 80 mg decreased insulin sensitivity (1%, 3%, 3%, and 4%, respectively) when compared with either baseline or placebo.

The researchers concluded: "Despite beneficial reductions in LDL cholesterol and apolipoprotein B, atorvastatin treatment resulted in significant increases in fasting insulin and glycated hemoglobin levels consistent with insulin resistance and increased ambient glycemia in hypercholesterolemic patients."

Fascinating, especially given the prevalence of metabolic syndrome. Other statins will most likely be looked at.

For the full abstract, click here.

J Am Coll Cardiol 55:1209-1216, 23 March 2010 © 2010 by the American College of Cardiology Foundation
Atorvastatin Causes Insulin Resistance and Increases Ambient Glycemia in Hypercholesterolemic Patients. Kwang Kon Koh, Michael J. Quon, Seung Hwan Han et al. Correspondence to Kwang Kon Koh: [email protected]

Category: K. Circulatory. Keywords: adipocytokines, glycated hemoglobin, insulin resistance, metabolic syndrome, statins, randomized, single- blind, placebo-controlled parallel study, journal watch.
Synopsis edited by Dr Stephen Wilkinson, Melbourne, Australia. Posted on Global Family Doctor 14 May 2010

Pearls are an independent product of the Cochrane primary care group and are meant for educational use and not to guide clinical care.