阿托伐他汀(10mg/d)对代谢综合征患者糖代谢的影响

作     者：Huptas S. Geiss H.-C. Otto C. Parhofer K.G. 宁宁 

作者机构：Department of Internal Medicine II Klinikum Grosshadern Ludwig-Maximilians University Munich Germany 

出 版 物：《世界核心医学期刊文摘（心脏病学分册）》 (Digest of the World Core Medical Journals(Cardiology))

年 卷 期：2006年第2卷第11期

页      面：35-36页

学科分类：1002[医学-临床医学] 100201[医学-内科学(含：心血管病、血液病、呼吸系病、消化系病、内分泌与代谢病、肾病、风湿病、传染病)] 10[医学] 

主　　题：代谢综合征 mg/d 糖代谢 胰岛素抵抗 空腹血糖 空腹胰岛素 他汀类药物 耐量试验 脂类 白细胞介 

摘      要：Large interventional studies have shown that statins may reduce the incidence of type 2 diabetes mellitus. However, it is uncertain whether short-term statin therapy can affect insulin sensitivity in patients with the metabolic syndrome. We evaluated the effect of atorvastatin(10 mg/day) in 10 insulin-resistant subjects(age 40±12 years, body mass index 33.6±5.2 kg/m2, triglycerides 2.84±1.99 mmol/L[249±175mg/dl], glucose 6.06±0.67 mmol/L[109±12 mg/dl]) using the homeostasis model assessment(HOMA) index(parameter of insulin resistance derived from fasting glucose and fasting insulin concentrations; 5.7±2.6) in a randomized placebo-controlled, double-blind, crossover study. Subjects were randomized to receive placebo or atorvastatin, each given for 6 weeks separated by a 6-week wash-out period. At the beginning and end of each treatment phase, the patients underwent an oral glucose tolerance test, a 72-hour continuous glucose measurement, and a detailed lipid determination, including a standardized fat tolerance test. Compared with placebo, atorvastatin resulted in a significant(p=0.05) reduction in the HOMA index(-21%), fasting C-peptides(-18%), glucose(area under the curve during the oral glucose tolerance test,-7%), and a borderline(p=0.08) reduction of insulin(-18%). The parameters derived from the continuous 72-hour glucose monitoring did not change. A significant reduction also occurred in the total and low-density lipoprotein cholesterol concentrations, although the fasting and postprandial triglyceride concentrations did not change significantly. However, we found a significant correlation between atorvastatin-induced changes in the HOMA and baseline HOMA and between the atorvastatin-induced changes in triglycerides and insulin concentrations. The free-fatty acid, interleukin-6, and high sensitivity C-reactive protein concentrations did not change. Our data indicated that in insulin-resistant, nondiabetic subjects, 6 weeks of atorvastatin(10 mg/day) resulted i