Kwang Kon Koh1, Pyung Chun Oh2, Ichiro Sakuma3, Yonghee Lee4, Seung Hwan Han2, Eak Kyun Shin2. 1. Cardiology, Gachon University Gil Medical Center, Incheon, Republic of Korea; Gachon Cardiovascular Research Institute, Incheon, Republic of Korea. Electronic address: kwangk@gilhospital.com. 2. Cardiology, Gachon University Gil Medical Center, Incheon, Republic of Korea; Gachon Cardiovascular Research Institute, Incheon, Republic of Korea. 3. Cardiovascular Medicine, Hokko Memorial Clinic, Sapporo, Japan. 4. Department of Statistics, University of Seoul, Seoul, Republic of Korea.
Abstract
BACKGROUND: Genetic analysis from patients participated in the randomized trials reported that the increased risk of type 2 diabetes noted with statins is at least partially explained by HMG-coenzyme A reductase inhibition. We investigated vascular and metabolic phenotypes of different dosages of rosuvastatin in hypercholesterolemic patients. METHODS: A randomized, single-blind, placebo-controlled, parallel study was conducted in 48 patients on placebo, and in 47, 48, and 47 patients givendaily rosuvastatin 5, 10, and 20mg, respectively during a 2month treatment period. RESULTS:Rosuvastatin 5, 10, and 20mg improved flow-mediated dilation (34, 40, and 46%) after 2months therapy when compared with baseline (P<0.001 by paired t-test) and when compared with placebo (P<0.001 by ANOVA). Rosuvastatin 5,10, and 20mg dose-dependently and significantly increased insulin (mean % changes; 19, 29, and 31%, respectively) and glycated hemoglobin levels (mean % changes; 2, 2, and 3%, respectively), and decreased adiponectin levels (mean % changes; 3, 9, and 14%, respectively) and insulin sensitivity (mean % changes; 2, 3, and 4%, respectively) after 2months therapy when compared with baseline (all P<0.05 by paired t-test). These effects with rosuvastatin 5, 10, and 20mg were significant when compared with placebo (P=0.006 for insulin, P=0.012 for glycated hemoglobin, P=0.007 for adiponectin, and P=0.002 for insulin sensitivity by ANOVA). CONCLUSIONS: Despite beneficial reductions in LDL cholesterol and improvement of flow-mediated dilation, rosuvastatin dose-dependently and significantly resulted in decreasing insulin sensitivity and increasing ambient glycemia by reducing adiponectin levels and increasing insulin levels in hypercholesterolemic patients.
RCT Entities:
BACKGROUND: Genetic analysis from patients participated in the randomized trials reported that the increased risk of type 2 diabetes noted with statins is at least partially explained by HMG-coenzyme A reductase inhibition. We investigated vascular and metabolic phenotypes of different dosages of rosuvastatin in hypercholesterolemicpatients. METHODS: A randomized, single-blind, placebo-controlled, parallel study was conducted in 48 patients on placebo, and in 47, 48, and 47 patients given daily rosuvastatin 5, 10, and 20mg, respectively during a 2month treatment period. RESULTS:Rosuvastatin 5, 10, and 20mg improved flow-mediated dilation (34, 40, and 46%) after 2months therapy when compared with baseline (P<0.001 by paired t-test) and when compared with placebo (P<0.001 by ANOVA). Rosuvastatin 5,10, and 20mg dose-dependently and significantly increased insulin (mean % changes; 19, 29, and 31%, respectively) and glycated hemoglobin levels (mean % changes; 2, 2, and 3%, respectively), and decreased adiponectin levels (mean % changes; 3, 9, and 14%, respectively) and insulin sensitivity (mean % changes; 2, 3, and 4%, respectively) after 2months therapy when compared with baseline (all P<0.05 by paired t-test). These effects with rosuvastatin 5, 10, and 20mg were significant when compared with placebo (P=0.006 for insulin, P=0.012 for glycated hemoglobin, P=0.007 for adiponectin, and P=0.002 for insulin sensitivity by ANOVA). CONCLUSIONS: Despite beneficial reductions in LDL cholesterol and improvement of flow-mediated dilation, rosuvastatin dose-dependently and significantly resulted in decreasing insulin sensitivity and increasing ambient glycemia by reducing adiponectin levels and increasing insulin levels in hypercholesterolemicpatients.
Authors: Alexander Hodkinson; Dialechti Tsimpida; Evangelos Kontopantelis; Martin K Rutter; Mamas A Mamas; Maria Panagioti Journal: BMJ Date: 2022-03-24