High-Dose Statin Therapy Does Not Induce Insulin Resistance in Patients with Familial Hypercholesterolemia
| Autor: | Gillian J. Pilcher, Frederick J. Raal, Andrew Immelman, Janice Paiker, Vanessa R. Panz |
|---|---|
| Rok vydání: | 2012 |
| Předmět: |
Adult
Male medicine.medical_specialty Adolescent Endocrinology Diabetes and Metabolism medicine.medical_treatment Familial hypercholesterolemia Carotid Intima-Media Thickness Hyperlipoproteinemia Type II Coronary artery disease Young Adult Insulin resistance Internal medicine Internal Medicine Hyperinsulinemia Humans Medicine Child Proinsulin Dose-Response Relationship Drug Adiponectin business.industry Insulin nutritional and metabolic diseases Middle Aged medicine.disease Lipids Endocrinology Intima-media thickness Female Hydroxymethylglutaryl-CoA Reductase Inhibitors Insulin Resistance business hormones hormone substitutes and hormone antagonists |
| Zdroj: | Metabolic Syndrome and Related Disorders. 10:351-357 |
| ISSN: | 1557-8518 1540-4196 |
| DOI: | 10.1089/met.2012.0063 |
| Popis: | Insulin resistance is thought to play a pathophysiological role in the development of atherosclerosis. Decreased adiponectin levels are associated with hyperinsulinemia, insulin resistance, and coronary artery disease. Patients with familial hypercholesterolemia (FH) develop premature atherosclerosis and should be insulin resistant and have low adiponectin levels.A total of 51 homozygous FH (HoFH) and 20 heterozygous FH (HeFH) patients were studied before and after statin therapy. Twenty normocholesterolemic subjects were controls. Fasting lipograms, glucose, insulin, proinsulin, adiponectin, and high-sensitivity C-reactive protein (hsCRP) were measured. Insulin resistance was calculated with the homeostasis model assessment (HOMA-IR) formula. Carotid intima media thickness (CIMT) was measured as a subclinical marker of atherosclerosis.On multiple regression analysis, the major determinant of insulin resistance measured by HOMA-IR was body mass index (BMI) (r=0.54; P=0.004). On simple linear regression, the highest correlation was with BMI (r=0.39; P=0.0002). Log hsCRP correlated with BMI (r=0.35; P0.002) and insulin resistance (r=0.22; P=0.05). Low-density lipoprotein cholesterol (LDL-C) and CIMT did not correlate with insulin resistance. Unexpectedly, adiponectin levels were highest in HoFH patients and correlated with LDL-C (r=0.34; P=0.001). No change in the degree of IR was observed with statin therapy.FH patients are not insulin resistant and do not have low adiponectin levels. There was no significant change in insulin resistance with high-dose statin therapy. |
| Databáze: | OpenAIRE |
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