The Effect of HMG-CoA reductase inhibitor on insulin resistance in patients undergoing peritoneal dialysis

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

doi:10.1007/s10557-012-6412-2

The Effect of HMG-CoA reductase inhibitor on insulin resistance in patients undergoing peritoneal dialysis

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

Department of Internal Medicine

Research output: Contribution to journal › Article › peer-review

9 Citations (Scopus)

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 (n0 35) or a control group (n035). 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 (P00.014). There was a concordant decrease in hsCRP levels in the statin group (2.05 ±1.57 to 1.21±0.84 mg/L, P0.001), 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 (P00.021 for between-group difference), whereas HOMA-IR index was not (P00.189 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.

Original language	English
Pages (from-to)	501-509
Number of pages	9
Journal	Cardiovascular Drugs and Therapy
Volume	26
Issue number	6
DOIs	https://doi.org/10.1007/s10557-012-6412-2
Publication status	Published - 2012 Dec

Bibliographical note

Funding Information:
Acknowledgment This work was supported by the Yonsei University (Brain Korea 21) Project for Medical Sciences, a grant from the Korea Science and Engineering Foundation funded by the Korean government (MOST) (R13-2002-054-04001-0), and a grant of the Korea Healthcare Technology R&D Project of the Ministry for Health, Welfare & Family Affairs, Republic of Korea (A084001).

All Science Journal Classification (ASJC) codes

Pharmacology
Cardiology and Cardiovascular Medicine
Pharmacology (medical)

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10.1007/s10557-012-6412-2

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@article{9baedf5152114f25b08991b4f792a4fd,

title = "The Effect of HMG-CoA reductase inhibitor on insulin resistance in patients undergoing peritoneal dialysis",

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 (n0 35) or a control group (n035). 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 (P00.014). There was a concordant decrease in hsCRP levels in the statin group (2.05 ±1.57 to 1.21±0.84 mg/L, P0.001), 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 (P00.021 for between-group difference), whereas HOMA-IR index was not (P00.189 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.",

author = "Doh, {Fa Mee} and Chang, {Tae Ik} and Koo, {Hyang Mo} and Lee, {Mi Jung} and Shin, {Dong Ho} and Kim, {Chan Ho} and Ko, {Kwang Il} and Oh, {Hyung Jung} and Yoo, {Tae Hyun} and Kang, {Shin Wook} and Han, {Dae Suk} and Han, {Seung Hyeok}",

note = "Funding Information: Acknowledgment This work was supported by the Yonsei University (Brain Korea 21) Project for Medical Sciences, a grant from the Korea Science and Engineering Foundation funded by the Korean government (MOST) (R13-2002-054-04001-0), and a grant of the Korea Healthcare Technology R&D Project of the Ministry for Health, Welfare & Family Affairs, Republic of Korea (A084001).",

year = "2012",

month = dec,

doi = "10.1007/s10557-012-6412-2",

language = "English",

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issn = "0920-3206",

publisher = "Kluwer Academic Publishers",

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T1 - The Effect of HMG-CoA reductase inhibitor on insulin resistance in patients undergoing peritoneal dialysis

AU - Doh, Fa Mee

AU - Chang, Tae Ik

AU - Koo, Hyang Mo

AU - Lee, Mi Jung

AU - Shin, Dong Ho

AU - Kim, Chan Ho

AU - Ko, Kwang Il

AU - Oh, Hyung Jung

AU - Yoo, Tae Hyun

AU - Kang, Shin Wook

AU - Han, Dae Suk

AU - Han, Seung Hyeok

N1 - Funding Information: Acknowledgment This work was supported by the Yonsei University (Brain Korea 21) Project for Medical Sciences, a grant from the Korea Science and Engineering Foundation funded by the Korean government (MOST) (R13-2002-054-04001-0), and a grant of the Korea Healthcare Technology R&D Project of the Ministry for Health, Welfare & Family Affairs, Republic of Korea (A084001).

PY - 2012/12

Y1 - 2012/12

N2 - 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 (n0 35) or a control group (n035). 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 (P00.014). There was a concordant decrease in hsCRP levels in the statin group (2.05 ±1.57 to 1.21±0.84 mg/L, P0.001), 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 (P00.021 for between-group difference), whereas HOMA-IR index was not (P00.189 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.

AB - 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 (n0 35) or a control group (n035). 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 (P00.014). There was a concordant decrease in hsCRP levels in the statin group (2.05 ±1.57 to 1.21±0.84 mg/L, P0.001), 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 (P00.021 for between-group difference), whereas HOMA-IR index was not (P00.189 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.

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The Effect of HMG-CoA reductase inhibitor on insulin resistance in patients undergoing peritoneal dialysis

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