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High-dose simvastatin has no effect on insulin action, ectopic lipid deposition
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LDL-lowering with high-dose simvastatin did not directly improve whole-body or hepatic insulin sensitivity and intracellular lipid deposition in patients with type 2 diabetes and hypercholesterolemia, according to new study findings.
The randomized, double blind, placebo-controlled study included 20 patients with type 2 diabetes. Each patient was randomly assigned to 80 mg simvastatin or placebo per day for eight weeks. The researchers used a comparison group of 10 healthy controls.
Patients who received high-dose simvastatin experienced a 33% reduction in plasma total cholesterol levels and 48% reduction in LDL levels (P<.005).
However, the researchers reported no effect of simvastatin on insulin sensitivity, intracellular lipid deposition in muscle and liver or basal and insulin-suppressed endogenous glucose production.
There was a negative relationship between changes in LDL and insulin sensitivity (r=–0.796; P<.01) and changes in fasting free fatty acids and insulin sensitivity (r=–0.840; P<.01) among patients assigned to simvastatin. Researchers reported that changes in free fatty acids related positively to plasma retinol-binding protein-4 (r=0.0782; P=.008).
“Increases in HDL and decreases in fasting triglycerides and free fatty acids were not observed in our patients with only slight hypertriglyceridemia. Simvastatin might, therefore, exert larger effects on HDL and triglycerides in more severe hypertriglyceridemia,” the researchers wrote.
Diabetes Care. 2009;32:209-214.
Effects of High-Dose Simvastatin on
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