Cited by 229Lipoproteins and Cardiovascular HealthDiabetes, Cardiovascular Risks, and LipoproteinsCancer, Lipids, and Metabolism

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Atorvastatin Causes Insulin Resistance and Increases Ambient Glycemia in Hypercholesterolemic Patients

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Koh, Kwang Kon, Quon, Michael J., Han, Seung Hwan, Lee, Yonghee, Kim, Soo Jin, Shin, Eak Kyun·2010·Journal of the American College of Cardiology

DOI 10.1016/j.jacc.2009.10.053PMC PMC3016087

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Abstract

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).

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Authors: Koh, K. K., Quon, M. J., Han, S. H., Lee, Y., Kim, S. J., & Shin, E. K.
Affiliations: Gachon University Gil Medical Center (KR)
National Institutes of Health (US)
University of Seoul (KR)
Corresponding author: Koh, Kwang Kon
ORCID: Koh, Kwang Kon
Quon, Michael J.
Han, Seung Hwan
Lee, Yonghee
Kim, Soo Jin
Venue: Journal of the American College of Cardiology
Publisher: Elsevier BV
Published: 2010-03
Volume: 55
Issue: 12
Pages: 1209-1216
ISSN: 0735-1097 (ISSN-L)
DOI: 10.1016/j.jacc.2009.10.053
PMC: PMC3016087
OpenAlex: W2052703897
Cited by: 229
References: 27
Citations by year: 2026: 4 · 2025: 10 · 2024: 9 · 2023: 16 · 2022: 9 · 2021: 8 · 2020: 5 · 2019: 13 · 2018: 9 · 2017: 11 · 2016: 13 · 2015: 18 · 2014: 31 · 2013: 23 · 2012: 23
FWCI: 24.66
Type: journal article
Language: en
Open access: bronze
doi.org
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
www.elsevier.com/legal/tdmrep-license (tdm)
www.elsevier.com/open-access/userlicense/1.0/ (vor, 1270 d)
Locations: Journal of the American College of Cardiology (publishedVersion)
PubMed (publishedVersion)
PubMed Central (acceptedVersion)
Funders: established investigator award
Gachon University Gil Hospital
Intramural Research Program, National Center for Complementary and Alternative Medicine, National Institutes of Health
Topics: Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Lipoproteins and Cardiovascular Health
Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
Life Sciences › Biochemistry, Genetics and Molecular Biology › Cancer Research › Cancer, Lipids, and Metabolism
Keywords: atorvastatin, insulin resistance, hypercholesterolemia, statins, fasting insulin, HbA1c, LDL cholesterol, apolipoprotein B, diabetes risk, dose-dependent effects, endothelial dysfunction, endothelial nitric oxide synthase, nitric oxide, nitric oxide synthase inhibition, hypertriglyceridemia
MeSH terms: Atorvastatin, Adult, Aged, Blood Glucose, Double-Blind Method, Female, Heptanoic Acids, Humans, Hypercholesterolemia, Insulin, Insulin Resistance, Male, Middle Aged, Pyrroles, Treatment Outcome, Hydroxymethylglutaryl-CoA Reductase Inhibitors

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Atorvastatin Causes Insulin Resistance and Increases Ambient Glycemia in Hypercholesterolemic Patients

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