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Risk of insulin resistance with statin therapy in individuals without dyslipidemia: A propensity‐matched analysis in a registry population
Author(s) -
Hyun Myung Han,
Jang Jae Won,
Choi Byoung Geol,
Na Jin Oh,
Choi Cheol Ung,
Kim Jin Won,
Kim Eung Ju,
Rha SeungWoon,
Park Chang Gyu,
Lee Eunmi,
Seo Hong Seog
Publication year - 2020
Publication title -
clinical and experimental pharmacology and physiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.752
H-Index - 103
eISSN - 1440-1681
pISSN - 0305-1870
DOI - 10.1111/1440-1681.13272
Subject(s) - dyslipidemia , medicine , insulin resistance , statin , endocrinology , diabetes mellitus , insulin , population , environmental health
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.