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HMG CoA Reductase Inhibitor Treatment Induces Dysglycemia in Renal Allograft Recipients

 Eun Yeong Choe  ;  Hye Jin Wang  ;  Obin Kwon  ;  Yongin Cho  ;  Kyu Ha Huh  ;  Myoung Soo Kim  ;  Yu Seun Kim  ;  Chul Woo Ahn  ;  Bong Soo Cha  ;  Hyun Chul Lee  ;  Eun Seok Kang 
 TRANSPLANTATION, Vol.97(4) : 419-425, 2014 
Journal Title
Issue Date
Adult ; Anticholesteremic Agents/adverse effects ; Atorvastatin Calcium ; Blood Glucose/biosynthesis* ; Diabetes Complications/diagnosis ; Diabetes Mellitus/diagnosis ; Dyslipidemias/chemically induced ; Fasting ; Fatty Acids, Monounsaturated/adverse effects ; Female ; Follow-Up Studies ; Glomerular Filtration Rate ; Heptanoic Acids/adverse effects ; Humans ; Hydroxymethylglutaryl-CoA Reductase Inhibitors/adverse effects* ; Hyperglycemia/complications ; Hyperglycemia/etiology* ; Immunosuppressive Agents/therapeutic use ; Incidence ; Indoles/adverse effects ; Kidney Transplantation/methods* ; Male ; Middle Aged ; Pyrroles/adverse effects ; Renal Insufficiency/complications* ; Renal Insufficiency/therapy
BACKGROUND: Dysglycemia and dyslipidemia are important metabolic complications of organ transplantation. Statins are widely used to control dyslipidemia; however, long-term use of statins is related to diabetes mellitus (DM) and impaired fasting glucose (IFG). The aim of this study was to evaluate the influence of statins on the development of dysglycemia (IFG and/or DM) in renal allograft recipients. METHODS: A total of 394 patients without previously known DM or IFG who underwent kidney transplantation were enrolled. Patients were grouped into the two groups according to the use of statin (control, n=149; statin, n=245). The major statins used were fluvastatin (80 mg/d, n=134) and atorvastatin (20 mg/d, n=111). We compared the incidence of IFG or DM during the follow-up period. RESULTS: The incidence of IFG was higher in the statin group than that in the control group (28.6% vs. 8.7%, P<0.001). The incidence of dysglycemia was significantly higher in the statin group (40.0% vs. 15.4%, P=0.001). Time to development of dysglycemia after transplantation was shorter in the statin group than in the control group (38.8±29.7 vs. 47.2±23.3 months, P=0.002). Statin use was associated with an increased risk for dysglycemia after adjustment for age, sex, body mass index, hypertension, cholesterol levels, hepatitis C infection, and type of immunosuppressant (hazard ratio=3.08, 95% confidence interval=1.91-4.98). The dysglycemic effect was more profound in the patients who used atorvastatin than in those who used fluvastatin (hazard ratio=2.21, 95% confidence interval=1.02-4.76). CONCLUSION: Statin treatment is associated with an elevation in fasting plasma glucose and in the development of dysglycemia in renal allograft recipients.
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Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Yonsei Biomedical Research Center (연세의생명연구원) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Pharmacology (약리학교실) > 1. Journal Papers
Yonsei Authors
Kang, Eun Seok(강은석) ORCID logo https://orcid.org/0000-0002-0364-4675
Kwon, O Bin(권오빈)
Kim, Myoung Soo(김명수) ORCID logo https://orcid.org/0000-0002-8975-8381
Kim, Yu Seun(김유선) ORCID logo https://orcid.org/0000-0002-5105-1567
Ahn, Chul Woo(안철우) ORCID logo https://orcid.org/0000-0003-3733-7486
Wang, Hye Jin(왕혜진)
Lee, Hyun Chul(이현철)
Cho, Yong In(조용인) ORCID logo https://orcid.org/0000-0002-4645-816X
Cha, Bong Soo(차봉수) ORCID logo https://orcid.org/0000-0003-0542-2854
Choe, Eun Yeong(최은영)
Huh, Kyu Ha(허규하) ORCID logo https://orcid.org/0000-0003-1364-6989
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