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Zaki JK, Lago SG, Spadaro B, Rustogi N, Gangadin SS, Benacek J, Drexhage HA, de Witte LD, Kahn RS, Sommer IEC, Bahn S, Tomasik J. Exploring peripheral biomarkers of response to simvastatin supplementation in schizophrenia. Schizophr Res 2024; 266:66-74. [PMID: 38377869 DOI: 10.1016/j.schres.2024.02.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Revised: 02/02/2024] [Accepted: 02/11/2024] [Indexed: 02/22/2024]
Abstract
Schizophrenia is one of the most debilitating mental disorders, and its diagnosis and treatment present significant challenges. Several clinical trials have previously evaluated the effectiveness of simvastatin, a lipid-lowering medication, as a novel add-on treatment for schizophrenia. However, treatment effects varied highly between patients and over time. In the present study, we aimed to identify biomarkers of response to simvastatin in recent-onset schizophrenia patients. To this end, we profiled relevant immune and metabolic markers in patient blood samples collected in a previous clinical trial (ClinicalTrials.gov: NCT01999309) before simvastatin add-on treatment was initiated. Analysed sample types included serum, plasma, resting-state peripheral blood mononuclear cells (PBMCs), as well as PBMC samples treated ex vivo with immune stimulants and simvastatin. Associations between the blood readouts and clinical endpoints were evaluated using multivariable linear regression. This revealed that changes in insulin receptor (IR) levels induced in B-cells by ex vivo simvastatin treatment inversely correlated with in vivo effects on cognition at the primary endpoint of 12 months, as measured using the Brief Assessment of Cognition in Schizophrenia scale total score (standardised β ± SE = -0.75 ± 0.16, P = 2.2 × 10-4, Q = 0.029; n = 21 patients). This correlation was not observed in the placebo group (β ± SE = 0.62 ± 0.39, P = 0.17, Q = 0.49; n = 14 patients). The candidate biomarker explained 53.4 % of the variation in cognitive outcomes after simvastatin supplementation. Despite the small sample size, these findings suggest a possible interaction between the insulin signalling pathway and cognitive effects during simvastatin therapy. They also point to opportunities for personalized schizophrenia treatment through patient stratification.
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Affiliation(s)
- Jihan K Zaki
- Department of Chemical Engineering and Biotechnology, University of Cambridge, Cambridge, UK
| | - Santiago G Lago
- Department of Chemical Engineering and Biotechnology, University of Cambridge, Cambridge, UK
| | - Benedetta Spadaro
- Department of Chemical Engineering and Biotechnology, University of Cambridge, Cambridge, UK
| | - Nitin Rustogi
- Department of Chemical Engineering and Biotechnology, University of Cambridge, Cambridge, UK
| | - Shiral S Gangadin
- Department of Biomedical Sciences of Cells & Systems, University Medical Center Groningen (UMCG), University of Groningen, Groningen, the Netherlands
| | - Jiri Benacek
- Department of Chemical Engineering and Biotechnology, University of Cambridge, Cambridge, UK
| | - Hemmo A Drexhage
- Department of Immunology, Erasmus Medical Center, Rotterdam, the Netherlands
| | - Lot D de Witte
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - René S Kahn
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Department of Psychiatry, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Iris E C Sommer
- Department of Biomedical Sciences of Cells & Systems, University Medical Center Groningen (UMCG), University of Groningen, Groningen, the Netherlands; Department of Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Sabine Bahn
- Department of Chemical Engineering and Biotechnology, University of Cambridge, Cambridge, UK.
| | - Jakub Tomasik
- Department of Chemical Engineering and Biotechnology, University of Cambridge, Cambridge, UK.
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Does Pitavastatin Therapy for Patients with Type 2 Diabetes and Dyslipidemia Affect Serum Adiponectin Levels and Insulin Sensitivity? J Clin Med 2022; 11:jcm11226756. [PMID: 36431233 PMCID: PMC9692324 DOI: 10.3390/jcm11226756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 11/07/2022] [Accepted: 11/12/2022] [Indexed: 11/17/2022] Open
Abstract
(1) Background: We aimed to demonstrate the effects of pitvastatin therapy on the serum levels of total adiponectin and high-molecular-weight (HMW) adiponectin in type 2 diabetes and the correlation with insulin sensitivity. (2) Methods: This study was designed as an open-labelled randomized trial. Patients with diabetes who were prescribed pitavastatin therapy were enrolled and randomized to either treatment with 2 mg of pitavastatin once daily (n = 44) (PITA group) or diet and exercise only, except their antidiabetic medications (n = 49), for 24 weeks. (3) Results: In lipid profiles, the reduction in total cholesterol (TC) and low-density lipoprotein cholesterol (LDL-C) was significantly increased in the PITA group (TC; 207.5 ± 20 vs. 195.5 ± 30.0 ng/dL, p < 0.001, LDL-C; 132.0 ± 15.8 vs. 123.1 ± 25.7 mg/dL, p < 0.001). Adiponectin and HMW adiponectin were elevated in the PITA group, compared to the control group without significance. The PITA group showed a lower level of HOMA-IR and HOMA-β levels. However, there was no significance (HOMA-IR; p = 0.5921 -at 12 weeks and p = 0.3645 at 24 weeks; HOMA-β; p = 0.8915 at 12 weeks and p = 0.7313 in 6 months). (4) Conclusions: The present study did not show a significant change in serum adiponectin or HMW adiponectin from baseline in serum adiponectin following pitavastatin therapy. Although statin has been considered as a risk for dysglycemia, pitavastatin did not affect insulin sensitivity.
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Liu J, Wu YP, Qi JJ, Yue ZP, Hu CD. Effect of Statin Therapy on Diabetes Retinopathy in People With Type 2 Diabetes Mellitus: A Meta-Analysis. Clin Appl Thromb Hemost 2021; 27:10760296211040109. [PMID: 34617462 PMCID: PMC8642113 DOI: 10.1177/10760296211040109] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Objective: We tried to find the relationship between statin and
diabetes retinopathy (DR) in patients with type 2 diabetes mellitus (T2DM).
Methods: We searched the databases of PubMed, EMBASE, and
the Cochrane Library for eligible studies reporting on the relationships between
statin use and DR, from inception to September 25, 2020. The terms searched
including Diabetes Mellitus, Type 2, Hydroxymethylglutaryl-CoA Reductase
Inhibitors, and Diabetic Retinopathy. We expressed the results as the odds
ratios (ORs) with 95% confidence intervals (CIs) which were calculated using a
random-effects model. Results: A total of 6 eligible studies,
including 43 826 patients, were included in the meta-analysis. The meta-analysis
showed that statin was not associated with elevated risk of DR [OR = 0.96 (95%
CI: 0.80-1.16), P = .68]. Similarly, no differences were found
between statin and placebo in participants ≥500 [OR = 0.98 (95% CI: 0.80-1.21)]
or participants <500 [OR = 0.90 (95% CI: 0.49-1.66)]. Further, we conducted a
meta-analysis to study the effect of statin therapy on DR in people with type 2
diabetes according to age and found that statin use was associated with a
decreased risk of DR in patients with type 2 diabetes 40 years of age or older
[OR = 0.87 (95% CI: 0.82-0.92)]. Conclusion: Our meta-analysis revealed
that statin was not associated with elevated risk of DR in patients with
T2DM. Moreover, statin use was associated with a lower incidence of DR in
patients with type 2 diabetes 40 years of age or older.
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Affiliation(s)
- Jun Liu
- Handan Central Hospital, Handan, Hebei Province, China
| | - Yi-Ping Wu
- Handan Central Hospital, Handan, Hebei Province, China
| | - Jun-Juan Qi
- Handan Central Hospital, Handan, Hebei Province, China
| | - Zeng-Ping Yue
- Handan Central Hospital, Handan, Hebei Province, China
| | - Cheng-Dong Hu
- Handan Central Hospital, Handan, Hebei Province, China
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Haxhi J, Thompson PD. Rationale for the use of metformin and exercise to counteract statin-associated side effects. Int J Clin Pract 2021; 75:e13900. [PMID: 33277775 DOI: 10.1111/ijcp.13900] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Accepted: 12/01/2020] [Indexed: 12/16/2022] Open
Abstract
INTRODUCTION Statins are the most widely prescribed drugs for lowering low-density lipoprotein cholesterol (LDL-C) and reducing cardiovascular morbidity and mortality. They are usually well-tolerated, but have two main safety concerns: statin-associated muscle symptoms (SAMS) and new-onset type 2 diabetes (NOD). METHODS A PubMed search was carried out using the following key words were used: statins, statin-associated muscle symptoms, statin myalgia, statin-associated diabetes, metformin and statins, exercise and statins. RESULTS Mitochondrial damage and muscle atrophy are likely the central mechanisms producing SAMS, whereas decreased glucose transport, fatty acid oxidation and insulin secretion are likely involved in the development of NOD. Metformin and exercise training share many pathways that could potentially contrast SAMS and NOD. Clinical evidence also supports the combination of statins with metformin and exercise. CONCLUSION This combination appears attractive both from a clinical and an economical viewpoint, since all three therapies are highly cost-effective and their combination could result in diabetes and cardiovascular disease prevention.
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Affiliation(s)
- Jonida Haxhi
- Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy
- Division of Cardiology, Hartford Hospital, Hartford, CT, USA
| | - Paul D Thompson
- Division of Cardiology, Hartford Hospital, Hartford, CT, USA
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Poorhosseini H, Tavolinejad H, Aminorroaya A, Soleimani H, Aasham O, Jalali A, Mohammadi A, Beigi SS, Sadeghian S, Bagheri J, Tajdini M. The association of statins for secondary prevention with progression to diabetes in patients with prediabetic state after coronary artery bypass graft surgery: A retrospective cohort study. J Diabetes Complications 2020; 34:107713. [PMID: 32900589 DOI: 10.1016/j.jdiacomp.2020.107713] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2020] [Revised: 06/20/2020] [Accepted: 08/18/2020] [Indexed: 02/06/2023]
Abstract
AIM Despite proven benefits of statins for secondary prevention of coronary artery diseases, their diabetogenic effect is still controversial. We aimed to examine the occurrence of type 2 diabetes mellitus (T2DM) in prediabetic patients after coronary artery bypass grafting (CABG). METHODS The retrospective cohort population comprised of post-CABG patients who were prediabetic at the time of surgery and were taking statins. Patients were categorized into the high- and low-intensity statin regimens according to the commonly used dose during the follow-up. Moreover, we calculated the cumulative dose (milligrams*days) by taking into account that patients were on different doses of statins during different periods of time. We observed patients for occurrence of T2DM or major adverse cardiovascular events (MACE) as a composite of death, myocardial infarction, cerebrovascular accident, and hospitalization for unstable angina or heart failure. RESULTS We studied 819 patients for a median of 37.8 months after CABG. T2DM occurred in 8.1% (n = 66). The rate of T2DM development was not different between the high- and low-intensity groups (P = 0.715) and also according to the cumulative dose (P = 0.962). Furthermore, we found no association (P = 0.938) even after adjustment for confounders including age, sex, body mass index, alcohol use, history of hypertension and hyperlipidemia, and family history of T2DM. Moreover, high- rather than low-intensity statin regimen was correlated with a lower occurrence of MACE (P = 0.027), even after adjustment for confounders (P = 0.015). CONCLUSIONS In prediabetic post-CABG patients, treatment with statins was not associated with the development of T2DM and reduced occurrence of MACE after 37 months.
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Affiliation(s)
| | - Hamed Tavolinejad
- Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran.
| | - Arya Aminorroaya
- Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran; Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
| | | | - Ozra Aasham
- Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Arash Jalali
- Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran.
| | - Ario Mohammadi
- Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Saeed Sadeghian
- Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran.
| | - Jamshid Bagheri
- Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran.
| | - Masih Tajdini
- Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran.
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Corrao G, Monzio Compagnoni M, Cantarutti A, Rea F, Merlino L, Catapano AL, Mancia G. Balancing cardiovascular benefit and diabetogenic harm of therapy with statins: Real-world evidence from Italy. Diabetes Res Clin Pract 2020; 164:108197. [PMID: 32389742 DOI: 10.1016/j.diabres.2020.108197] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2020] [Revised: 04/27/2020] [Accepted: 04/29/2020] [Indexed: 10/24/2022]
Abstract
AIM To provide information on the balance between the cardiovascular (CV) benefit and the diabetogenic harm of statin therapy in the current clinical practice. METHODS All the 115,939 residents (older than 50 years) in the Italian Lombardy Region newly treated with statins between 2003 and 2005, were followed from the first statin prescription until 2012 to identify those experiencing a macrovascular complication and those with at least one sign suggestive of new onset diabetes. The proportion of days of follow-up covered by statin prescriptions measured adherence with statins. Hazard ratio, and relative 95% confidence interval (CI), for the two considered outcomes associated with statin adherence, were separately estimated (proportional hazard models). Number needed to treat (NNT) and number needed to harm (NNH), i.e., number of individuals who must be treated with statins in order to prevent a macrovascular complication, or to generate a new onset diabetes, respectively, were calculated to evaluate the balance between CV benefit and diabetogenic harm of statin therapy. RESULTS Compared to those at very low adherence with statins, patients at high adherence showed a significant reduction of macrovascular risk (28%, 95% CI: 23%-33%) and a greater risk of developing diabetic condition (67%, 50%-86%). In the whole cohort, the NNT was 26, whereas the NNH 65. NNT was lower than NNH also in all considered strata of age, gender, clinical profile. CONCLUSIONS This large cohort investigation provides real-world evidence that the balance between CV benefit and diabetogenic harm of statin therapy is largely favourable to treatment benefits.
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Affiliation(s)
- Giovanni Corrao
- Center of Healthcare Research & Pharmacoepidemiology, Department of Statistics and Quantitative Methods, University of Milano-Bicocca, Milan, Italy; Division of Biostatistics, Epidemiology and Public Health, Department of Statistics and Quantitative Methods, University of Milano-Bicocca, Milan, Italy.
| | - Matteo Monzio Compagnoni
- Center of Healthcare Research & Pharmacoepidemiology, Department of Statistics and Quantitative Methods, University of Milano-Bicocca, Milan, Italy; Division of Biostatistics, Epidemiology and Public Health, Department of Statistics and Quantitative Methods, University of Milano-Bicocca, Milan, Italy.
| | - Anna Cantarutti
- Center of Healthcare Research & Pharmacoepidemiology, Department of Statistics and Quantitative Methods, University of Milano-Bicocca, Milan, Italy; Division of Biostatistics, Epidemiology and Public Health, Department of Statistics and Quantitative Methods, University of Milano-Bicocca, Milan, Italy.
| | - Federico Rea
- Center of Healthcare Research & Pharmacoepidemiology, Department of Statistics and Quantitative Methods, University of Milano-Bicocca, Milan, Italy; Division of Biostatistics, Epidemiology and Public Health, Department of Statistics and Quantitative Methods, University of Milano-Bicocca, Milan, Italy.
| | - Luca Merlino
- Regional Health Ministry, Lombardy Region, Milan, Italy.
| | - Alberico L Catapano
- Department of Pharmacological and Biomolecular Sciences, Centre of Epidemiology and Preventive Pharmacology (SEFAP), University of Milano, Milan, Italy; IRCSS Multimedica, Sesto San Giovanni, Milan, Italy.
| | - Giuseppe Mancia
- Professor Emeritus of Medicine, University of Milano-Bicocca, Milan, Italy.
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Chen YH, Yang YC, Chen W, Lin YN, Hung YC. Risk of macrovascular complications in statin-treated patients developing diabetes. Diabetes Res Clin Pract 2019; 157:107870. [PMID: 31560961 DOI: 10.1016/j.diabres.2019.107870] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Revised: 09/11/2019] [Accepted: 09/23/2019] [Indexed: 10/26/2022]
Abstract
AIMS To assess the risk of macrovascular complications in patients developing diabetes from statin treatment. METHODS In this population-based cohort study, 40,409 participants who began to receive statin therapy between 2000 and 2012 were enrolled in to the study group, and another 1:1 matched adults without statin treatment during the same period served as the control group. Both groups were followed up to identify individuals who later developed diabetes. After a follow-up identification of diabetes, diabetes and non-diabetes cohorts were subjected to an analysis for the risk of macrovascular events between diagnosis of diabetes and December 31, 2013. RESULTS Compared with individuals without statin therapy, statin-treated patients had a higher risk of developing diabetes (adjusted hazard ratio: 2.46; 95% confidence interval: 2.37-2.57). Compared with statin-treated patients without diabetes, statin-treated participants developing diabetes had a higher overall incidence of macrovascular complications (adjusted hazard ratio: 1.74; 95% confidence interval: 1.62-1.88). Moreover, compared with that of other diabetogenic statins, patients taking pravastatin had a lower risk of developing diabetes (adjusted hazard ratio: 0.63; 95% confidence interval: 0.55-0.73) and macrovascular events (adjusted hazard ratio: 0.64; 95% confidence interval: 0.42-0.98). CONCLUSIONS According to these findings, prescribing statins that have a neutral effect on glucose homeostasis may be advisable for Asian populations.
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Affiliation(s)
- Yin-Huei Chen
- Division of Endocrinology and Metabolism, Department of Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Yu-Cih Yang
- Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan; College of Medicine, China Medical University, Taichung, Taiwan
| | - Weishan Chen
- Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan; College of Medicine, China Medical University, Taichung, Taiwan
| | - Yen-Nien Lin
- Division of Cardiovascular Medicine, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan; Graduate Institute of Clinical Medical Science, China Medical University, Taichung, Taiwan; Cardiovascular Research Laboratory, China Medical University Hospital, Taichung, Taiwan
| | - Yi-Chih Hung
- Division of Endocrinology and Metabolism, Department of Medicine, China Medical University Hospital, Taichung, Taiwan; Graduate Institute of Clinical Medical Science, China Medical University, Taichung, Taiwan.
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Seshadri S, Rapaka N, Prajapati B, Mandaliya D, Patel S, Muggalla CS, Kapadia B, Babu PP, Misra P, Saxena U. Statins exacerbate glucose intolerance and hyperglycemia in a high sucrose fed rodent model. Sci Rep 2019; 9:8825. [PMID: 31217552 PMCID: PMC6584635 DOI: 10.1038/s41598-019-45369-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2018] [Accepted: 05/31/2019] [Indexed: 12/22/2022] Open
Abstract
Statins are first-line therapy drugs for cholesterol lowering. While they are highly effective at lowering cholesterol, they have propensity to induce hyperglycemia in patients. Only limited studies have been reported which studied the impact of statins on (a) whether they can worsen glucose tolerance in a high sucrose fed animal model and (b) if so, what could be the molecular mechanism. We designed studies using high sucrose fed animals to explore the above questions. The high sucrose fed animals were treated with atorvastatin and simvastatin, the two most prescribed statins. We examined the effects of statins on hyperglycemia, glucose tolerance, fatty acid accumulation and insulin signaling. We found that chronic treatment with atorvastatin made the animals hyperglycemic and glucose intolerant in comparison with diet alone. Treatment with both statins lead to fatty acid accumulation and inhibition of insulin signaling in the muscle tissue at multiple points in the pathway.
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Affiliation(s)
| | - Naimisha Rapaka
- Dr. Reddy's Institute of Life Sciences, University of Hyderabad Campus, Gachibowli, Hyderabad, 500 046, India
| | | | | | - Sweta Patel
- Institute of Science, Nirma University, Ahmedabad, India
| | - Christopher Shamir Muggalla
- Dr. Reddy's Institute of Life Sciences, University of Hyderabad Campus, Gachibowli, Hyderabad, 500 046, India
| | - Bandish Kapadia
- Dr. Reddy's Institute of Life Sciences, University of Hyderabad Campus, Gachibowli, Hyderabad, 500 046, India.,Marlene & Stewart Greene Baum Cancer Center, Department of Medicine, University of Maryland, Baltimore, Maryland, United States of America
| | - Phanithi Prakash Babu
- Department of Biotechnology & Bioinformatics, School of Life Sciences, University of Hyderabad, Gachibowli, Hyderabad, 500 046, India
| | - Parimal Misra
- Dr. Reddy's Institute of Life Sciences, University of Hyderabad Campus, Gachibowli, Hyderabad, 500 046, India.
| | - Uday Saxena
- Dr. Reddy's Institute of Life Sciences, University of Hyderabad Campus, Gachibowli, Hyderabad, 500 046, India.
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Bengaluru Jayanna M, Robinson JG. The extent to which statins have improved cardiovascular outcomes: Lessons from randomized trials and observational studies of "real world" practice in people with diabetes. Diabetes Obes Metab 2019; 21 Suppl 1:17-27. [PMID: 31002457 DOI: 10.1111/dom.13701] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2018] [Revised: 03/05/2019] [Accepted: 03/06/2019] [Indexed: 01/05/2023]
Abstract
Statins are the mainstay of therapy for cardiovascular risk reduction in patients with diabetes mellitus. It is estimated that there are more than half a billion patients with diabetes mellitus worldwide and the numbers of prevalent cases of diabetes are expected to increase in both developed and developing countries in the next decade. Statins reduce risk of mortality and morbidity mainly by reducing blood low density cholesterol. Statins, along with other medical treatments, are responsible for about half of the decrease in cardiovascular mortality over the past several decades. Multiple clinical trials have found evidence for statin use in patients with diabetes, for both primary prevention and secondary prevention. The benefit of statins in patients with coronary heart disease and diabetes in terms of absolute risk reduction is twice as much as compared to the risk in patients with coronary heart disease but no diabetes. The proportion of patients with diabetes treated with statins has increased steadily over the past few decades with concurrent decrease in cardiovascular deaths in this high-risk population. However, there are significant unmet needs in cardiovascular risk reduction, due to underutilization of statins and due to residual cardiovascular risk despite maximal statin therapy. Future strategies in population risk reduction in diabetics should include maximal statin therapy, additional treatment with nonstatin therapy and new paradigms of prevention with early intervention with shorter, more intensive therapy to potentially "reverse" atherosclerosis with goals of reducing clinical cardiovascular disease later in life.
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Affiliation(s)
| | - Jennifer G Robinson
- College of Public Health, Carver College of Medicine, University of Iowa, Iowa City, Iowa
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Statin treatment and increased diabetes risk. Possible mechanisms. CLINICA E INVESTIGACION EN ARTERIOSCLEROSIS 2019; 31:228-232. [PMID: 30737072 DOI: 10.1016/j.arteri.2018.12.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/28/2018] [Revised: 11/26/2018] [Accepted: 12/16/2018] [Indexed: 01/30/2023]
Abstract
Statins have been associated with an increased risk of new-onset diabetes mellitus (NODM), as confirmed in previous observational studies and meta-analyses. Controversy exists as to whether this risk varies depending on statin type or dose. However, there appears to be unanimity regarding the different associated factors that raise this risk. Furthermore, diverse pathophysiologic mechanisms have been described that could explain the increased risk of diabetes in patients with statin treatment. These fundamentally cause a rise in insulin resistance together with a decrease in insulin secretion. The present review aimed to describe the relationship between statin treatment and the presence of diabetes and provide an update of previous published evidence and the possible mechanisms involved.
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Matsubara T, Takakura N, Urata M, Muramatsu Y, Tsuboi M, Yasuda K, Addison WN, Zhang M, Matsuo K, Nakatomi C, Shigeyama-Tada Y, Kaneuji T, Nakamichi A, Kokabu S. Geranylgeraniol Induces PPARγ Expression and Enhances the Biological Effects of a PPARγ Agonist in Adipocyte Lineage Cells. In Vivo 2019; 32:1339-1344. [PMID: 30348686 DOI: 10.21873/invivo.11384] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2018] [Revised: 07/31/2018] [Accepted: 08/06/2018] [Indexed: 12/11/2022]
Abstract
BACKGROUND The global incidence of diabetes mellitus (DM) has risen precipitously, even in middle- and low-income countries. Peroxisome proliferator-activated receptor γ (PPARγ) plays an important role in the control of cellular glucose metabolism. Activation of PPARγ beneficially results in increased insulin sensitivity. However, the expression of PPARγ is reduced by obesity and several nutritional factors. Here we examined the effect of geranylgeraniol (GGOH), a bioactive compound found naturally in fruits, vegetables, and grains, on the expression and activation of PPARγ. MATERIALS AND METHODS C3H10T1/2 mouse embryonic fibroblasts and 3T3-L1 pre-adipocytes were used as in vitro models of adipocyte differentiation and function. Quantitative reverse-transcriptase polymerase chain reaction, western blotting, Oil Red O staining, and luciferase assay were performed to respectively assess mRNA expression, protein levels, lipid droplet formation and transcriptional activity. RESULTS GGOH increased the expression of PPARγ in adipocyte lineage cells. GGOH also enhanced adipogenesis induced by rosiglitazone, a thiazolidinedione class PPARγ agonist. CONCLUSION GGOH induces PPARγ expression and enhances the biological effects of a PPARγ agonist in adipocyte lineage cells.
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Affiliation(s)
- Takuma Matsubara
- Division of Molecular Signaling and Biochemistry, School of Oral Health Sciences, Kyushu Dental University, Kitakyushu, Japan
| | - Nana Takakura
- Division of Molecular Signaling and Biochemistry, School of Oral Health Sciences, Kyushu Dental University, Kitakyushu, Japan
| | - Mariko Urata
- Division of Molecular Signaling and Biochemistry, School of Oral Health Sciences, Kyushu Dental University, Kitakyushu, Japan
| | - Yuya Muramatsu
- Division of Molecular Signaling and Biochemistry, School of Oral Health Sciences, Kyushu Dental University, Kitakyushu, Japan
| | - Makoto Tsuboi
- Division of Molecular Signaling and Biochemistry, School of Oral Health Sciences, Kyushu Dental University, Kitakyushu, Japan
| | - Kazuma Yasuda
- Division of Molecular Signaling and Biochemistry, School of Oral Health Sciences, Kyushu Dental University, Kitakyushu, Japan
| | - William N Addison
- Research Unit, Shriners Hospitals for Children-Canada, Department of Human Genetics, McGill University, Montreal, QC, Canada
| | - Min Zhang
- Division of Oral Pathology, Department of Health Promotion, School of Oral Health Sciences, Kyushu Dental University, Kitakyushu, Japan
| | - Kou Matsuo
- Division of Oral Pathology, Department of Health Promotion, School of Oral Health Sciences, Kyushu Dental University, Kitakyushu, Japan
| | - Chihiro Nakatomi
- Division of Molecular Signaling and Biochemistry, School of Oral Health Sciences, Kyushu Dental University, Kitakyushu, Japan
| | - Yukiyo Shigeyama-Tada
- Division of Dental Anesthesiology, Department of Control of Physical Functions, School of Oral Health Sciences, Kyushu Dental University, Kitakyushu, Japan
| | - Takeshi Kaneuji
- Division of Oral and Maxillofacial Surgery, Department of Medicine of Sensory and Motor Organs, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan
| | - Atsuko Nakamichi
- Department of Oral Functional Management, School of Oral Health Sciences, Kyushu Dental University, Kitakyushu, Japan
| | - Shoichiro Kokabu
- Division of Molecular Signaling and Biochemistry, School of Oral Health Sciences, Kyushu Dental University, Kitakyushu, Japan
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12
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Latek D, Rutkowska E, Niewieczerzal S, Cielecka-Piontek J. Drug-induced diabetes type 2: In silico study involving class B GPCRs. PLoS One 2019; 14:e0208892. [PMID: 30650080 PMCID: PMC6334951 DOI: 10.1371/journal.pone.0208892] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2018] [Accepted: 11/27/2018] [Indexed: 01/10/2023] Open
Abstract
A disturbance of glucose homeostasis leading to type 2 diabetes mellitus (T2DM) is one of the severe side effects that may occur during a prolonged use of many drugs currently available on the market. In this manuscript we describe the most common cases of drug-induced T2DM, discuss available pharmacotherapies and propose new ones. Among various pharmacotherapies of T2DM, incretin therapies have recently focused attention due to the newly determined crystal structure of incretin hormone receptor GLP1R. Incretin hormone receptors: GLP1R and GIPR together with the glucagon receptor GCGR regulate food intake and insulin and glucose secretion. Our study showed that incretin hormone receptors, named also gut hormone receptors as they are expressed in the gastrointestinal tract, could potentially act as unintended targets (off-targets) for orally administrated drugs. Such off-target interactions, depending on their effect on the receptor (stimulation or inhibition), could be beneficial, like in the case of incretin mimetics, or unwanted if they cause, e.g., decreased insulin secretion. In this in silico study we examined which well-known pharmaceuticals could potentially interact with gut hormone receptors in the off-target way. We observed that drugs with the strongest binding affinity for gut hormone receptors were also reported in the medical information resources as the least disturbing the glucose homeostasis among all drugs in their class. We suggested that those strongly binding molecules could potentially stimulate GIPR and GLP1R and/or inhibit GCGR which could lead to increased insulin secretion and decreased hepatic glucose production. Such positive effect on the glucose homeostasis could compensate for other, adverse effects of pharmacotherapy which lead to drug-induced T2DM. In addition, we also described several top hits as potential substitutes of peptidic incretin mimetics which were discovered in the drug repositioning screen using gut hormone receptors structures against the ZINC15 compounds subset.
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Affiliation(s)
- Dorota Latek
- Faculty of Chemistry, University of Warsaw, Warsaw, Poland
| | | | | | - Judyta Cielecka-Piontek
- Department of Pharmacognosy, Faculty of Pharmacy, Poznan University of Medical Sciences, Poznan, Poland
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13
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Corrao G, Monzio Compagnoni M, Rea F, Merlino L, Catapano AL, Mancia G. Clinical significance of diabetes likely induced by statins: Evidence from a large population-based cohort. Diabetes Res Clin Pract 2017; 133:60-68. [PMID: 28892732 DOI: 10.1016/j.diabres.2017.08.008] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2017] [Revised: 07/13/2017] [Accepted: 08/14/2017] [Indexed: 01/05/2023]
Abstract
AIM To provide information on the extent to which type 2 diabetes more likely induced by statins affects the risk of macrovascular complications compared to diabetes unlikely induced by statins. METHODS The 84,828 residents in the Italian Lombardy Region who were newly treated with statins between 2003 and 2005 were followed from the index statin prescription until 2009 (step-1 follow-up) to identify those starting antidiabetic therapy. The proportion of days of follow-up covered by statins measured adherence with statins. Cohort members who experienced diabetes were 1:3 matched with those who did not developed diabetes for gender, age and previous adherence with statin treatment. The 3321 diabetic - non-diabetic sets, were followed from the initial antidiabetic therapy until 2012 (step-2 follow-up) to estimate the hazard ratio (HR), and 95% Confidence Interval (CI), for macrovascular complications (proportional hazard models) associated with diabetes separately in each category of adherence with statins. RESULTS During the step-1 follow-up, the risk of new-onset diabetes increased progressively with increasing adherence with statins. During the step-2 follow-up, the risk of macrovascular complications associated with diabetes decreased progressively from 1.70 (1.18-2.44), 1.41 (1.17-1.70), 1.30 (1.07-1.57) until 1.10 (0.40-2.80) as adherence with statins during the step-1 follow-up increased. CONCLUSIONS Type 2 diabetes lost its association with increasing macrovascular risk when previous adherence with statins was very high, and thus the chance of its induction by the drug greater. Statin-dependent type 2 diabetes might be prognostically less adverse than diabetes unlikely induced by statins.
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Affiliation(s)
- Giovanni Corrao
- Interuniversity Centre of Healthcare Research & Pharmacoepidemiology, Laboratory of Healthcare Research & Pharmacoepidemiology, University of Milano-Bicocca, Milan, Italy; Department of Statistics and Quantitative Methods, Division of Biostatistics, Epidemiology and Public Health, University of Milano-Bicocca, Milan, Italy.
| | - Matteo Monzio Compagnoni
- Interuniversity Centre of Healthcare Research & Pharmacoepidemiology, Laboratory of Healthcare Research & Pharmacoepidemiology, University of Milano-Bicocca, Milan, Italy; Department of Statistics and Quantitative Methods, Division of Biostatistics, Epidemiology and Public Health, University of Milano-Bicocca, Milan, Italy
| | - Federico Rea
- Interuniversity Centre of Healthcare Research & Pharmacoepidemiology, Laboratory of Healthcare Research & Pharmacoepidemiology, University of Milano-Bicocca, Milan, Italy; Department of Statistics and Quantitative Methods, Division of Biostatistics, Epidemiology and Public Health, University of Milano-Bicocca, Milan, Italy
| | - Luca Merlino
- Operative Unit of Territorial Health Services, Lombardy Region, Milan, Italy
| | - Alberico L Catapano
- Department of Pharmacological and Biomolecular Sciences, Centre of Epidemiology and Preventive Pharmacology (SEFAP), University of Milano, Milan, Italy; IRCSS Multimedica, Sesto San Giovanni, Milan, Italy
| | - Giuseppe Mancia
- Faculty of Medicine, University of Milano-Bicocca, Milan, Italy
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14
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Rochlani Y, Kattoor AJ, Pothineni NV, Palagiri RDR, Romeo F, Mehta JL. Balancing Primary Prevention and Statin-Induced Diabetes Mellitus Prevention. Am J Cardiol 2017; 120:1122-1128. [PMID: 28797470 DOI: 10.1016/j.amjcard.2017.06.054] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2017] [Revised: 06/11/2017] [Accepted: 06/29/2017] [Indexed: 11/19/2022]
Abstract
Diabetes mellitus (DM), a modern-day epidemic, is a significant risk factor for cardiovascular disease. It is believed that statins elevate the risk of incident DM. Multiple trials were suggestive of the hyperglycemic effect of long-term statin use. This has prompted the Food and Drug Administration to include the risk of DM in the product label of statins. New-onset DM with statin use is biologically plausible and can be explained based on the multiple pathways in glucose metabolism affected by statins. Most pivotal clinical trials on statins were not powered to adequately assess the risk of incident DM with statin use, and the results from multiple meta-analyses are mixed. Currently, the US Preventive Services Task Force recommend the use of statins for primary prevention in patients with at least 1 cardiovascular risk factor and a 10-year risk of >7.5%. With the new American College of Cardiology/American Heart Association guidelines, the number of patients eligible for statin therapy has increased exponentially, which also calls for caution and increased vigilance in prescribing physicians regarding the controversies surrounding statin use. This article aims to highlight the existing data on statin use for primary prevention in diabetics and nondiabetics and the association of statins use with new-onset DM and its postulated mechanisms.
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Affiliation(s)
- Yogita Rochlani
- Division of Cardiology, University of Arkansas for Medical Sciences, Little Rock, Arkansas
| | - Ajoe John Kattoor
- Division of Cardiology, University of Arkansas for Medical Sciences, Little Rock, Arkansas
| | - Naga Venkata Pothineni
- Division of Cardiology, University of Arkansas for Medical Sciences, Little Rock, Arkansas
| | | | - Francesco Romeo
- Division of Cardiology, University of Rome Tor Vergata, Rome, Italy
| | - Jawahar L Mehta
- Division of Cardiology, University of Arkansas for Medical Sciences, Little Rock, Arkansas.
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15
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Abstract
The hydroxyl-methyl-glutaryl-coenzyme-A (HMG-CoA) reductase inhibitors of statin action are very effective and safe drugs, and they are widely used for the treatment of hyperlipidemia and the prevention of primary and secondary cardiovascular diseases (CVDs). However, recent meta-analyses of previous studies done with statins have shown that these drugs could induce new onset diabetes mellitus (NODM), especially in subjects prone to diabetes: obese, females, older age, Asian descent, and those with pre-diabetes or the metabolic syndrome. Several meta-analyses of randomized, controlled trials with statins and population-based studies of subjects taking statins have shown different incidence of NODM ranging from 28% in the JUPITER study to 43% in the UK clinical practice cohort. The exact cause of statin-induced NODM is not clearly known and several pathophysiologic mechanisms have been proposed, which include modification of the lipoprotein particle size, inhibition of HMG-CoA reductase, decreased expression of GLUT 4, and decreased adiponectin and ubiquinone levels, including others, which all lead to either increase in insulin resistance or decrease in insulin secretion. Based on the current evidence, the use of statins should not be withheld from subjects at high cardiovascular risk, even if they are prone to NODM, because their benefits outweigh their risks. However, in persons prone to the development of NODM, vigilance is required and periodic measurements of plasma glucose or HbA1c should be performed. If NODM develops, statin treatment should not be stopped, but a switch to administration of a more favorable statin, administration of statin on alternate days, or reduction of the dose should be considered, or antidiabetic therapy added.
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Affiliation(s)
- Steven G Chrysant
- a University of Oklahoma College of Medicine , Oklahoma City , OK , US
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16
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In situ eNOS/NO up-regulation-a simple and effective therapeutic strategy for diabetic skin ulcer. Sci Rep 2016; 6:30326. [PMID: 27453476 PMCID: PMC4958962 DOI: 10.1038/srep30326] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2016] [Accepted: 07/04/2016] [Indexed: 01/04/2023] Open
Abstract
Decreased nitric oxide (NO) synthesis and increased NO consumption in diabetes induces the inadequate blood flow to tissues that is primarily responsible for the pathogenesis and refractoriness of diabetic skin ulcers. The present study proposed a simple and effective therapeutic strategy for diabetic skin ulcers—in situ up-regulation of endothelial nitric oxide synthase (eNOS) expression and NO synthesis by statin-loaded tissue engineering scaffold (TES). In vitro experiments on human umbilical vein endothelial cells indicated that the statin-loaded TES relieved the high-glucose induced decrease in cell viability and promoted NO synthesis under high-glucose conditions. In a rat model of diabetes, the statin-loaded TES promoted eNOS expression and NO synthesis in/around the regenerated tissues. Subsequently, accelerated vascularization and elevated blood supply were observed, followed by rapid wound healing. These findings suggest that the in situ up-regulation of eNOS/NO by a statin-loaded TES may be a useful therapeutic method for intractable diabetic skin wounds.
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Capewell S, McCartney M, Holland W. NHS Health Checks--a naked emperor? J Public Health (Oxf) 2016; 37:187-92. [PMID: 26022810 DOI: 10.1093/pubmed/fdv063] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Simon Capewell
- Department of Public Health and Policy, Institute of Psychology, Health and Society, University of Liverpool, Whelan Building, Quadrangle, Liverpool L69 3GB, UK
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Kain V, Kapadia B, Misra P, Saxena U. Simvastatin may induce insulin resistance through a novel fatty acid mediated cholesterol independent mechanism. Sci Rep 2015; 5:13823. [PMID: 26345110 PMCID: PMC4561915 DOI: 10.1038/srep13823] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2014] [Accepted: 08/06/2015] [Indexed: 11/30/2022] Open
Abstract
Statins are a class of oral drugs that are widely used for treatment of hypercholesterolemia. Recent clinical data suggest that chronic use of these drugs increases the frequency of new onset diabetes. Studies to define the risks of statin-induced diabetes and its underlying mechanisms are clearly necessary. We explored the possible mechanism of statin induced insulin resistance using a well-established cell based model and simvastatin as a prototype statin. Our data show that simvastatin induces insulin resistance in a cholesterol biosynthesis inhibition independent fashion but does so by a fatty acid mediated effect on insulin signaling pathway. These data may help design strategies for prevention of statin induced insulin resistance and diabetes in patients with hypercholesterolemia.
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Affiliation(s)
- Vasundhara Kain
- Department of Biology, Dr. Reddy's Institute of Life Sciences, University of Hyderabad Campus, Hyderabad, Telangana, India
| | - Bandish Kapadia
- Department of Biology, Dr. Reddy's Institute of Life Sciences, University of Hyderabad Campus, Hyderabad, Telangana, India
| | - Parimal Misra
- Department of Biology, Dr. Reddy's Institute of Life Sciences, University of Hyderabad Campus, Hyderabad, Telangana, India
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Pathogenesis and management of the diabetogenic effect of statins: a role for adiponectin and coenzyme Q10? Curr Atheroscler Rep 2015; 17:472. [PMID: 25398645 DOI: 10.1007/s11883-014-0472-7] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
There is growing evidence to suggest that statin therapy is associated with an increased risk of incident diabetes. The risk for statin-related diabetes depends upon many factors including age, pre-existing diabetic risk, type and potency of statin. Several mechanisms have been suggested for the diabetogenic effects of statins involving processes that alter islet ß-cell function, resulting in impaired glucose metabolism. Recent evidence suggests that the association of statin therapy with the development of diabetes may be partly mediated by a statin-induced decrease in circulating adiponectin and coenzyme Q10. The available evidence suggests the benefit of statins in reducing cardiovascular events outweigh the risk of developing diabetes. Moreover, statin therapy does not impair glycemic control in diabetic patients. Expert recommendations for the use of statins in people at risk of developing diabetes have recently been published. However, further research is required to elucidate both the association between statin use and incident diabetes as well as underlying mechanisms.
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20
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Arnaboldi L, Corsini A. Could changes in adiponectin drive the effect of statins on the risk of new-onset diabetes? The case of pitavastatin. ATHEROSCLEROSIS SUPP 2015; 16:1-27. [DOI: 10.1016/s1567-5688(14)70002-9] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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Dormuth CR, Filion KB, Paterson JM, James MT, Teare GF, Raymond CB, Rahme E, Tamim H, Lipscombe L. Higher potency statins and the risk of new diabetes: multicentre, observational study of administrative databases. BMJ 2014; 348:g3244. [PMID: 24874977 PMCID: PMC4038449 DOI: 10.1136/bmj.g3244] [Citation(s) in RCA: 120] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
OBJECTIVE To evaluate the incremental increase in new onset diabetes from higher potency statins compared with lower potency statins when used for secondary prevention. DESIGN Eight population based cohort studies and a meta-analysis. SETTING Six Canadian provinces and two international databases from the UK and US. PARTICIPANTS 136,966 patients aged ≥ 40 years newly treated with statins between 1 January 1997 and 31 March 2011. METHODS Within each cohort of patients newly prescribed a statin after hospitalisation for a major cardiovascular event or procedure, we performed as-treated, nested case-control analyses to compare diabetes incidence in users of higher potency statins with incidence in users of lower potency statins. Rate ratios of new diabetes events were estimated using conditional logistic regression on different lengths of exposure to higher potency versus lower potency statins; adjustment for confounding was achieved using high dimensional propensity scores. Meta-analytic methods were used to estimate overall effects across sites. MAIN OUTCOME MEASURES Hospitalisation for new onset diabetes, or a prescription for insulin or an oral antidiabetic drug. RESULTS In the first two years of regular statin use, we observed a significant increase in the risk of new onset diabetes with higher potency statins compared with lower potency agents (rate ratio 1.15, 95% confidence interval 1.05 to 1.26). The risk increase seemed to be highest in the first four months of use (rate ratio 1.26, 1.07 to 1.47). CONCLUSIONS Higher potency statin use is associated with a moderate increase in the risk of new onset diabetes compared with lower potency statins in patients treated for secondary prevention of cardiovascular disease. Clinicians should consider this risk when prescribing higher potency statins in secondary prevention patients.
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Affiliation(s)
- Colin R Dormuth
- Department of Anesthesiology, Pharmacology and Therapeutics, University of British Columbia, Victoria, BC V8W 1Y2, Canada
| | - Kristian B Filion
- Centre for Clinical Epidemiology, Lady Davis Institute, Jewish General Hospital, McGill University, Montreal, Canada
| | | | - Matthew T James
- Department of Medicine, University of Calgary, Calgary, Canada
| | | | - Colette B Raymond
- Manitoba Centre for Health Policy, University of Manitoba, Winnipeg, Canada
| | - Elham Rahme
- Department of Medicine, McGill University, Montreal, Canada
| | - Hala Tamim
- School of Kinesiology and Health Science, York University, Toronto, Canada
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Sahebkar A, Watts GF. Managing recalcitrant hypercholesterolemia in patients on current best standard of care: efficacy and safety of novel pharmacotherapies. ACTA ACUST UNITED AC 2014. [DOI: 10.2217/clp.14.14] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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23
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Bostan C, Yildiz A, Ozkan AA, Uzunhasan I, Kaya A, Yigit Z. Beneficial effects of rosuvastatin treatment in patients with metabolic syndrome. Angiology 2014; 66:122-7. [PMID: 24554427 DOI: 10.1177/0003319714522107] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
We determined the effect of 6-month rosuvastatin treatment on blood lipids, oxidative parameters, apolipoproteins, high-sensitivity C-reactive protein, lipoprotein(a), homocysteine, and glycated hemoglobin (HbA1c) in patients with metabolic syndrome (MetS). Healthy individuals (men aged >40 years and postmenopausal women) with a body mass index ≥ 30 (n = 100) who fulfilled the National Cholesterol Education Program Adult Treatment Panel III diagnostic criteria for MetS were included. Total cholesterol and low-density lipoprotein cholesterol (LDL-C) levels decreased (P < .0001). The change in LDL 1 to 3 subgroups was significant (P = .0007, P < .0001, and P = .006, respectively). Changes in LDL 4 to 7 subgroups were not significant. There was a beneficial effect on oxidized LDL, fibrinogen, homocysteine, and HbA1c. Rosuvastatin significantly increased high-density lipoprotein levels (P = .0003). The oxidant/antioxidant status and subclinical inflammatory state were also beneficially changed. Rosuvastatin had a significant beneficial effect on atherogenic dyslipidemia as well as on oxidative stress and inflammatory biomarkers in patients with MetS.
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Affiliation(s)
- Cem Bostan
- Department of Cardiology, Istanbul University Institute of Cardiology, Istanbul, Turkey
| | - Ahmet Yildiz
- Department of Cardiology, Istanbul University Institute of Cardiology, Istanbul, Turkey
| | - Alev Arat Ozkan
- Department of Cardiology, Istanbul University Institute of Cardiology, Istanbul, Turkey
| | - Isil Uzunhasan
- Department of Cardiology, Istanbul University Institute of Cardiology, Istanbul, Turkey
| | - Aysem Kaya
- Department of Biochemistry, Istanbul University Institute of Cardiology, Istanbul, Turkey
| | - Zerrin Yigit
- Department of Cardiology, Istanbul University Institute of Cardiology, Istanbul, Turkey
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