Deterioration of glucose homeostasis in type 2 diabetic patients one year after beginning of statins therapy

作者：Bellia Alfonso; Rizza Stefano; Lombardo Marco Felice; Donadel Giulia; Fabiano Rossella; Andreadi Katia; Quon Michael J; Sbraccia Paolo; Federici Massimo; Tesauro Manfredi; Cardillo Carmine; Lauro Davide^*

来源：Atherosclerosis, 2012, 223(1): 197-203.

DOI：10.1016/j.atherosclerosis.2012.04.015

• Statins
• Type 2 diabetes
• Insulin-resistance
• Insulin secretion

Objective: We evaluated the long-term effects of rosuvastatin and simvastatin on insulin sensitivity and secretion in patients with well-controlled type 2 diabetes. %26lt;br%26gt;Methods: After a 3 weeks run-in, 27 eligible patients were randomly assigned to receive either rosuvastatin 20 mg daily (Group 1) or simvastatin 20 mg daily (Group 2) for 6 months; thereafter they were switched to the other treatment for additional 6 months. Patients were recruited among individuals attending the outpatient service of the Diabetology Unit of the %26quot;Policlinico Tor Vergata%26quot; University Hospital, Rome, Italy. Serum lipids, glucose and insulin, glycated hemoglobin, C-reactive protein, TNF-alpha, leptin, adiponectin, insulin sensitivity by euglycemic-hyperinsulinemic clamp, beta-cells function by HOMA-beta were assessed at months 0, 6 and 12. Additionally, endothelial function was assessed by use of the brachial artery reactivity technique. %26lt;br%26gt;Results: Besides marked reduction in lipid levels, glycated hemoglobin significantly increased from baseline after 12 months in both Group 1 (+0.8 +/- 0.2%, p %26lt; 0.001) and Group 2 (+0.9 +/- 0.3%; p %26lt; 0.001). Similar trends were observed for fasting glucose in both groups. No changes in insulin sensitivity were detected throughout the study, whereas HOMA-beta significantly decreased from baseline after 12 months in both Group 1 (-21.9%, p %26lt; 0.01) and Group 2 (-38.9%; p %26lt; 0.001). In addition, both treatments similarly decreased C-reactive protein and leptin, as well as improved endothelial function. No changes in anthropometric measures were observed. %26lt;br%26gt;Conclusions: In well-controlled type 2 diabetic patients both rosuvastatin and simvastatin significantly impaired glycemic control and insulin secretion, without affecting insulin sensitivity.

• 出版日期2012-7