Differing effect of statins on insulin sensitivity in non-diabetics: A systematic review and meta-analysis

被引:149
作者
Baker, William L. [2 ]
Talati, Ripple [2 ]
White, C. Michael [2 ]
Coleman, Craig I. [1 ,2 ]
机构
[1] Univ Connecticut, Hartford Hosp, Evidence Based Practice Ctr, Hartford, CT 06102 USA
[2] Univ Connecticut, Sch Pharm, Storrs, CT USA
关键词
Statin; Insulin sensitivity; Meta-analysis; HOMA; QUICKI; C-REACTIVE PROTEIN; BETA-CELL FUNCTION; GLUCOSE-METABOLISM; PRAVASTATIN; CORONARY; ATORVASTATIN; ROSUVASTATIN; SIMVASTATIN; CHOLESTEROL; PREVENTION;
D O I
10.1016/j.diabres.2009.10.008
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background: To determine whether individual statins had differing effects on insulin sensitivity (IS) in patients without pre-existing diabetes mellitus. Methods: A systematic literature search of MEDLINE, EMBASE and Cochrane CENTRAL was conducted through December 2008. Trials were included if they compared pravastatin, atorvastatin, rosuvastatin or simvastatin to placebo/control, excluded patients with diabetes, and reported data on insulin sensitivity/resistance. IS data was pooled and evaluated as standardized mean differences (SMDs) and 95% confidence interval (CI) using a random-effects model. Results: 16 studies (n = 1146) were included, with patients receiving pravastatin in three trials (n = 164), atorvastatin in five trials (n = 315), rosuvastatin in five trials (n = 419), and simvastatin in five trials (n = 369). When pooled as a class, statins had no significant impact on IS as compared with placebo/control [SMD -0.084(95% CI -0.210to0.042);p = 0.19]. Pravastatin was found to significantly improved IS [SMD 0.342 (95% CI 0.032-0.621); p = 0.03], whereas simvastatin significantly worsened IS [SMD -0.321 (95% CI -0.526 to -0.117); p = 0.03]. Conclusions: Statins do not appear to demonstrate a 'class effect' on IS in patients without diabetes. Differences between individual statins likely exist that may partially explain the findings of previously conducted meta-analyses examining the impact of statins on the development of diabetes. (C) 2009 Elsevier Ireland Ltd. All rights reserved.
引用
收藏
页码:98 / 107
页数:10
相关论文
共 55 条
[1]   Statins, low-density lipoprotein cholesterol, and risk of cancer [J].
Alsheikh-Ali, Alawi A. ;
Trikalinos, Thomas A. ;
Kent, David M. ;
Karas, Richard H. .
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 2008, 52 (14) :1141-1147
[2]   No effect of simvastatin treatment on insulin sensitivity in patients with primary hypercholesterolemia [J].
Altunbas, H ;
Balci, MK ;
Karayalçin, Ü .
ENDOCRINE RESEARCH, 2003, 29 (03) :265-275
[3]  
[Anonymous], 2002, JAMA, V288, P2998
[4]   Intensive versus moderate lipid lowering with statins after acute coronary syndromes [J].
Cannon, CP ;
Braunwald, E ;
McCabe, CH ;
Rader, DJ ;
Rouleau, JL ;
Belder, R ;
Joyal, SV ;
Hill, KA ;
Pfeffer, MA ;
Skene, AM .
NEW ENGLAND JOURNAL OF MEDICINE, 2004, 350 (15) :1495-1504
[5]  
Chan DC, 2002, CLIN CHEM, V48, P877
[6]   The effect of statins on the development of new-onset type 2 diabetes: a meta-analysis of randomized controlled trials [J].
Coleman, Craig I. ;
Reinhart, Kurt ;
Kluger, Jeffrey ;
White, C. Michael .
CURRENT MEDICAL RESEARCH AND OPINION, 2008, 24 (05) :1359-1362
[7]   Primary prevention of cardiovascular disease with atorvastatin in type 2 diabetes in the Collaborative Atorvastatin Diabetes Study (CARDS): multicentre randomised placebo-controlled trial [J].
Colhoun, HM ;
Betteridge, DJ ;
Durrington, PN ;
Hitman, GA ;
Neil, HAW ;
Livingstone, SJ ;
Thomason, MJ ;
Mackness, MI ;
Charlton-Menys, V ;
Fuller, JH .
LANCET, 2004, 364 (9435) :685-696
[8]  
Collins R, 2002, LANCET, V360, P7, DOI 10.1016/S0140-6736(02)09327-3
[9]   Effects of atorvastatin on glucose homeostasis, postprandial triglyceride response and C-reactive protein in subjects with impaired fasting glucose [J].
Costa, A ;
Casamitjana, R ;
Casals, E ;
Alvarez, L ;
Morales, J ;
Masramón, X ;
Hernández, G ;
Gomis, R ;
Conget, I .
DIABETIC MEDICINE, 2003, 20 (09) :743-745
[10]   Statins and cancer risk - A meta-analysis [J].
Dale, KM ;
Coleman, CI ;
Henyan, NN ;
Kluger, J ;
White, CM .
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 2006, 295 (01) :74-80