The effect of statin treatment on glucose homeostasis in prediabetic individuals: A prospective, randomized, controlled trial.

Wan-Yin Cheng, Li-Hsin Chang, Harn-Shen Chen
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Abstract

Background: This study aimed to evaluate the effects of rosuvastatin and pravastatin on glucose homeostasis and other biomarkers in individuals at high risk of developing diabetes.

Methods: This prospective, randomized, open-labeled, and controlled trial included prediabetic individuals with impaired fasting glucose and impaired glucose tolerance. The participants were randomized into three groups: rosuvastatin (10 mg), pravastatin (40 mg), or control. Biomarkers of diabetes and glucose and insulin responses to oral glucose tolerance tests were assessed at baseline and after 6 months of treatment. The primary outcomes were comparisons of glucose homeostasis and biomarkers of diabetes among groups at baseline and after 6 months of treatment.

Results: A total of 141 subjects with impaired fasting glucose (IFG) were screened and 41 participants were recruited. Twenty-two subjects were randomized to either the rosuvastatin or pravastatin group and 19 subjects were assigned to the control group. After 6 months of treatment, all groups had similar cholesterol and triglyceride levels. Likewise, HbA1c levels, glucose, and insulin excursions during oral glucose tolerance test, were similar among the three groups. However, compared to the other groups, the rosuvastatin group had higher homeostasis model assessment for insulin resistance (HOMA-IR) (insulin resistance) and a lower Matsuda index (insulin sensitivity).

Conclusion: Among prediabetic individuals with IFG, rosuvastatin treatment was associated with increased insulin resistance and decreased insulin sensitivity compared to pravastatin and control groups. Further research is needed to elucidate the underlying mechanisms and clinical implications of these findings.

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他汀类药物治疗对糖尿病前期患者葡萄糖稳态的影响:前瞻性随机对照试验。
研究背景本研究旨在评估罗伐他汀和普伐他汀对糖尿病高危人群的葡萄糖稳态和其他生物标志物的影响:这项前瞻性、随机、开放标签和对照试验纳入了空腹血糖受损和糖耐量受损的糖尿病前期患者。参与者被随机分为三组:罗苏伐他汀(10 毫克)组、普伐他汀(40 毫克)组或对照组。在基线和治疗 6 个月后,对糖尿病生物标志物以及葡萄糖和胰岛素对口服葡萄糖耐量试验的反应进行了评估。主要结果是比较各组在基线和治疗 6 个月后的葡萄糖稳态和糖尿病生物标志物:结果:共筛选出 141 名 IFG 患者,并招募了 41 名参与者。22名受试者被随机分配到罗伐他汀或普伐他汀组,19名受试者被分配到对照组。经过 6 个月的治疗后,各组的胆固醇和甘油三酯水平相似。同样,三组的 HbA1c 水平、血糖和口服葡萄糖耐量试验中的胰岛素偏移量也相似。然而,与其他组相比,罗伐他汀组的HOMA-IR(胰岛素抵抗)较高,而松田指数(胰岛素敏感性)较低:结论:与普伐他汀组和对照组相比,在患有 IFG 的糖尿病前期患者中,罗伐他汀治疗与胰岛素抵抗增加和胰岛素敏感性降低有关。该试验已在他汀类药物对空腹血糖受损者葡萄糖稳态的影响和临床试验计划(ClinicalTrials.gov,NCT01816997)中注册。
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