Author + information
- Received July 8, 2009
- Revision received October 1, 2009
- Accepted October 12, 2009
- Published online March 23, 2010.
- Kwang Kon Koh, MD⁎,⁎ (, )
- Michael J. Quon, MD, PhD†,
- Seung Hwan Han, MD⁎,
- Yonghee Lee, PhD‡,
- Soo Jin Kim, RN⁎ and
- Eak Kyun Shin, MD⁎
- ⁎Department of Cardiology, Gachon University, Gil Medical Center, Incheon, Korea
- †Diabetes Unit, National Center for Complementary and Alternative Medicine, National Institutes of Health, Bethesda, Maryland
- ‡Department of Statistics, University of Seoul, Seoul, Korea
- ↵⁎Reprint requests and correspondence:
Dr. Kwang Kon Koh, Professor of Medicine, Director, Vascular Medicine and Atherosclerosis Unit, Cardiology, Gachon University Gil Hospital, 1198 Kuwol-dong, Namdong-gu, Incheon, Korea 405-760
Presented at the European Society of Cardiology 2009, Barcelona, Spain, August 29 to September 2, 2009, and American Heart Association Scientific Sessions 2009, Orlando, Florida, November 14 to 18, 2009.
Objectives We investigated whether atorvastatin might decrease insulin sensitivity and increase ambient glycemia in hypercholesterolemic patients.
Background 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.
Methods 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.
Results 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).
Conclusions 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)
This study was supported by grants from established investigator award (2005-1, 2006-1) (Dr. Koh), Gachon University Gil Hospital, and the Intramural Research Program, National Center for Complementary and Alternative Medicine, National Institutes of Health (NIH) (Dr. Quon).
- Received July 8, 2009.
- Revision received October 1, 2009.
- Accepted October 12, 2009.
- 2010 American College of Cardiology Foundation