Atorvastatin causes insulin resistance and increases ambient glycemia in hypercholesterolemic patients.
Atorvastatin causes insulin resistance and increases ambient glycemia in hypercholesterolemic patients.
复制标题
DOI：
10.1016/j.jacc.2009.10.053
复制
发表时间：
2010-03-23
影响因子：
24
通讯作者：
Shin, Eak Kyun
中科院分区：
文献类型：
--
作者：
Koh, Kwang Kon;Quon, Michael J.;Han, Seung Hwan;Lee, Yonghee;Kim, Soo Jin;Shin, Eak Kyun
我们调查了阿托伐他汀是否会降低高胆固醇血症患者的胰岛素敏感性并增加环境血糖。临床试验表明，尽管低密度脂蛋白(LDL)胆固醇降低，内皮功能障碍得到改善，但一些他汀类药物治疗可能会增加糖尿病的发病率。在为期2个月的治疗期间，44名服用安慰剂的患者和42名、44名、43名和40名患者分别每天服用阿托伐他汀10、20、40和80 mg，进行了随机、单盲、安慰剂对照的平行研究。阿托伐他汀10、20、40和80 mg在治疗2个月后显著降低低密度脂蛋白胆固醇(分别为39%、47%、52%和56%)和载脂蛋白B水平(分别为33%、37%、42%和46%)，与基线(所有P<；0.001通过配对t检验)或安慰剂(P<；0.001通过方差分析[ANOVA])相比。阿托伐他汀10、20、40和80毫克显著增加空腹血浆胰岛素(平均变化分别为25%、42%、31%和45%)和糖化血红蛋白水平(分别为2%、5%、5%和5%)，与基线(通过配对t检验全部P<；0.05)或安慰剂(经方差分析，胰岛素和糖化血红蛋白分别为p=0.009和p=0.008)相比显著增加。与基线(配对t检验分别为p=0.312、p=0.008、p<；0.001和p=0.008)或安慰剂(经方差分析p=0.033)相比，阿托伐他汀10、20、40和80 mg分别降低了胰岛素敏感性(分别为1%、3%、3%和4%)。尽管低密度脂蛋白胆固醇和载脂蛋白B得到了有益的降低，但阿托伐他汀治疗导致高胆固醇血症患者的空腹胰岛素和糖化血红蛋白水平显著增加，与胰岛素抵抗相一致，并增加了环境中的血糖。(阿托伐他汀对高胆固醇血症患者脂联素水平和胰岛素敏感性的影响；NCT00745836)
We investigated whether atorvastatin might decrease insulin sensitivity and increase ambient glycemia in hypercholesterolemic patients. 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. 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 (all p < 0.001 by paired t test) or placebo (p < 0.001 by analysis of variance [ANOVA]). 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 (all p < 0.05 by paired t test) or placebo (p = 0.009 for insulin and p = 0.008 for glycated hemoglobin by ANOVA). Atorvastatin 10, 20, 40, and 80 mg decreased insulin sensitivity (1%, 3%, 3%, and 4%, respectively) when compared with either baseline (p = 0.312, p = 0.008, p < 0.001, and p = 0.008, respectively, by paired t test) or placebo (p = 0.033 by ANOVA). 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. (Effects of Atorvastatin on Adiponectin Levels and Insulin Sensitivity In Hypercholesterolemic Patients; NCT00745836)
登录
查看更多内容
影响因子：
5.3
作者：
Koh, Kwang Kon;Quon, Michael J.;Han, Seung Hwan;Lee, Yonghee;Kim, Soo Jin;Park, Jeong Beorn;Shin, Eak Kyun
通讯作者：
Shin, Eak Kyun
影响因子：
168.9
作者：
Sever, PS;Dahlöf, B;Östergren, J
通讯作者：
Östergren, J
影响因子：
5.3
作者：
Takagi, Toshiyuki;Matsuda, Morihiro;Shimomura, Iichiro
通讯作者：
Shimomura, Iichiro
影响因子：
7.3
作者：
Yada, T;Nakata, M;Kakei, M
通讯作者：
Kakei, M
影响因子：
16.2
作者：
Keech, A;Colquhoun, D;Tonkin, A
通讯作者：
Tonkin, A