Comparison of the effects of simvastatin vs. rosuvastatin vs. simvastatin/ezetimibe on parameters of insulin resistance (Journal article)

Moutzouri, E./ Liberopoulos, E./ Mikhailidis, D. P./ Kostapanos, M. S./ Kei, A. A./ Milionis, H./ Elisaf, M. S.

BACKGROUND: Statin treatment may be associated with adverse effects on glucose metabolism. Whether this is a class effect is not known. In contrast, ezetimibe monotherapy may beneficially affect insulin sensitivity. OBJECTIVE: The aim of this study was to compare the effects of three different regimens of equivalent low-density lipoprotein cholesterol (LDL-C) lowering capacity on glucose metabolism. METHODS: A total of 153 patients (56 men), who had not achieved the LDL-C goal recommended by the National Cholesterol Education Program Adult Treatment Panel III (NCEP-ATP III) despite a 3-month dietary and lifestyle intervention, were randomly allocated to receive open-label simvastatin 40 mg or rosuvastatin 10 mg or simvastatin/ezetimibe 10/10 mg for 12 weeks. The primary end point was changes in homeostasis model assessment of insulin resistance (HOMA-IR). Secondary endpoints consisted of changes in fasting insulin levels, fasting plasma glucose (FPG), glycosylated haemoglobin (HbA(1c) ), the HOMA of beta-cell function (HOMA-B) (a marker of basal insulin secretion by pancreatic beta-cells), LDL-C and high sensitivity C reactive protein (hsCRP). RESULTS: At week 12, all three treatment regimens were associated with significant increases in HOMA-IR and fasting insulin levels (p < 0.05 compared with baseline). No significant difference was observed between groups. No change in FPG, HbA(1c) and HOMA-B levels compared with baseline were noted in any of the three treatment groups. Changes in serum lipids and hsCRP were similar across groups. CONCLUSION: To the extent that simvastatin 40 mg, rosuvastatin 10 mg and simvastatin/ezetimibe 10/10 mg are associated with adverse effects on insulin resistance, they appear to be of the same magnitude.
Institution and School/Department of submitter: Πανεπιστήμιο Ιωαννίνων. Σχολή Επιστημών Υγείας. Τμήμα Ιατρικής
Keywords: Aged,Azetidines/administration & dosage/*adverse effects,Blood Glucose/drug effects/metabolism,Body Mass Index,Cholesterol, LDL/metabolism,Drug Combinations,Fasting/blood,Female,Fluorobenzenes/administration & dosage/*adverse effects,Homeostasis/drug effects,Humans,Hydroxymethylglutaryl-CoA Reductase Inhibitors/administration & dosage/*adverse,effects,Hypercholesterolemia/*drug therapy,Insulin Resistance/*physiology,Male,Medication Adherence,Middle Aged,Pyrimidines/administration & dosage/*adverse effects,Simvastatin/administration & dosage/*adverse effects,Sulfonamides/administration & dosage/*adverse effects,Treatment Outcome
ISSN: 1742-1241
Appears in Collections:Άρθρα σε επιστημονικά περιοδικά ( Ανοικτά)

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