Risk of insulin resistance with statin therapy in individuals without dyslipidemia: A propensity-matched analysis in a registry population

Myung Han Hyun, Jae Won Jang, Byoung Geol Choi, Jin Oh Na, Cheol Ung Choi, Jin Won Kim, Eung Ju Kim, Seung Woon Rha, Chang Gyu Park, Eunmi Lee, Hong Seog Seo

Research output: Contribution to journalArticle

Abstract

Several studies suggest the higher vulnerability of individuals with lower low-density lipoprotein cholesterol (LDL-C) levels to diabetes mellitus. However, the discordance between high and low baseline LDL-C levels shown by statin-induced insulin resistance is not fully understood. This study aimed to explore the relationship between baseline LDL-C levels and the risk of statin-induced insulin resistance during statin therapy. In total, 2660 (451 with dyslipidemia and 2209 without dyslipidemia) consecutive patients were enrolled. Their baseline clinical data were adjusted using a propensity score matching analysis, using the logistic regression model. Insulin resistance index was based on the homeostatic model assessment-insulin resistance (HOMA-IR) and was monitored for a median of 2 years. Among the individuals who received statin therapy, those with and without dyslipidemia showed significantly decreased LDL-C levels (all P <.0001) and significantly increased fasting plasma insulin levels (Δ = +24.1%, P =.0230; Δ = +30.1%, P <.0001); however, their glycated haemoglobin A1c and fasting blood glucose levels did not change (all P >.05). Although HOMA-IR was positively associated with statin therapy in individuals with and without dyslipidemia, statistically significant difference during follow-ups was observed only in individuals without dyslipidemia (Δ = +15.6%, P =.1609; Δ = 24.0%; P =.0001). Insulin resistance was higher in statin users without baseline dyslipidemia than in those with dyslipidemia. Thus, statin therapy could increase the risk of statin-induced insulin resistance in individuals with normal baseline cholesterol levels.

Original languageEnglish
JournalClinical and Experimental Pharmacology and Physiology
DOIs
Publication statusAccepted/In press - 2020 Jan 1

Keywords

  • dyslipidemia
  • insulin resistance
  • statin

ASJC Scopus subject areas

  • Physiology
  • Pharmacology
  • Physiology (medical)

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