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The Effect of HMG-CoA Reductase Inhibitor on Insulin Resistance in Patients Undergoing Peritoneal Dialysis

Authors
 Fa Mee Doh  ;  Tae-Ik Chang  ;  Hyang Mo Koo  ;  Mi Jung Lee  ;  Dong Ho Shin  ;  Chan Ho Kim  ;  Kwang Il Ko  ;  Hyung Jung Oh  ;  Tae-Hyun Yoo  ;  Shin-Wook Kang  ;  Dae-Suk Han  ;  Seung Hyeok Han 
Citation
 Cardiovascular Drugs and Therapy, Vol.26(6) : 501-509, 2012 
Journal Title
 Cardiovascular Drugs and Therapy 
ISSN
 0920-3206 
Issue Date
2012
Abstract
BACKGROUND: Insulin resistance is associated with the progression of atherosclerosis and is reported to predict cardiovascular mortality in patients with end-stage renal disease (ESRD). Although statins exert pleiotropic effects, it is uncertain whether statin therapy improves insulin resistance in these patients. In this prospective randomized controlled trial, we aimed to evaluate the effects of statin on insulin resistance among 70 patients undergoing peritoneal dialysis (PD). METHODS: Patients were randomized into a statin group (n = 35) or a control group (n = 35). The statin group received 10 mg per day of rosuvastatin for 6 months. We determined insulin resistance by homeostatic model assessment of insulin resistance (HOMA-IR) index. Serum concentrations of adipokines such as adiponectin, leptin, and resistin were measured using enzyme-linked immunosorbent (ELISA) assay. As inflammatory markers, high sensitive C-reactive protein (hsCRP) and interleukin-6 were also measured. RESULTS: There were no significant differences in baseline characteristics between the two groups. Compared to baseline value, statin treatment significantly decreased HOMA-IR index from 2.37 ± 1.08 to 2.05 ± 0.82 (P = 0.014). There was a concordant decrease in hsCRP levels in the statin group (2.05 ± 1.57 to 1.21 ± 0.84 mg/L, P < 0.001), but such improvements were not observed in the control group. When between-group differences in these parameters were compared, hsCRP levels were more decreased in the statin group than in the control group (P = 0.021 for between-group difference), whereas HOMA-IR index was not (P = 0.189 for between-group difference). During this period, statin treatment did not result in the improved adipokine profiles. CONCLUSION: This study showed that statin therapy failed to improve insulin resistance in PD patients despite a significant decline in hsCRP levels after statin treatment. Our finding suggests that reducing inflammation by statin is of limited help to fully attenuate insulin resistance in these patients.
Full Text
http://link.springer.com/article/10.1007%2Fs10557-012-6412-2
DOI
10.1007/s10557-012-6412-2
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
강신욱(Kang, Shin Wook) ORCID logo https://orcid.org/0000-0002-5677-4756
고광일(Ko, Kwang Il)
구향모(Koo, Hyang Mo)
김찬호(Kim, Chan Ho)
도화미(Doh, Fa Mee) ORCID logo https://orcid.org/0000-0002-4780-6728
오형중(Oh, Hyung Jung)
유태현(Yoo, Tae Hyun) ORCID logo https://orcid.org/0000-0002-9183-4507
이미정(Lee, Mi Jung)
장태익(Chang, Tae Ik)
한대석(Han, Dae Suk)
한승혁(Han, Seung Hyeok) ORCID logo https://orcid.org/0000-0001-7923-5635
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URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/89895
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