jkd The Journal of Korean Diabetes J Korean Diabetes 2233-7431 2714-0547 Korean Diabetes Association 10.4093/jkd.2017.18.1.53 jkd-18-53 Original Article The Effect of Pravastatin on Insulin Resistance in Hyperglycemic Patients JeongYong Jin KimJung Min JangSeung Jae BangJun Hee JungYoung Gon KimSung Taek KangSoon Hyoung ChoiJong In KimSoo Sung KangMi Yeon Department of Internal Medicine, Saint Carollo Hospital, Suncheon, Korea Corresponding author: Mi Yeon Kang Division of Endocrinology and Metabolism, Department of Internal Medicine, Saint Carollo Hospital, 221 Sungwang-ro, Suncheon 57931, Korea, E-mail: leerabin@hanmail.net 01 2017 10 01 2017 18 1 53 61 06062015 29072016 20092016 Copyright © 2017 Korean Diabetes Association 2017 This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. Abstract Background

The effect of pravastatin on insulin resistance (IR) is controversial and poorly studied in prediabetes.

 Methods

This study was performed in hyperglycemic patients at Saint Carollo Hospital from January 1, 2013 to December 31, 2015. Among them, we selected 40 patients (24 prediabetes and 16 new onset diabetes [NOD]) who had been treated with pravastatin 20 mg daily for 2 or 4 months and in whom fasting insulin and fasting glucose had been measured before and after administration of pravastatin. IR was defined as a fasting insulin level ≥ 12.94 μU/mL, homeostasis model for IR (HOMA-IR) ≥ 3.04 or quantitative insulin sensitivity check index (QUICKI) ≤ 0.32.

 Results

Pravastatin treatment decreased total cholesterol and low-density lipoprotein cholesterol levels by 25.2% and 32.3% respectively (P = 0.000 for all), but did not affect fasting insulin level, HOMA-IR, or QUICKI in total, prediabetes, and NOD groups. Prevalence of IR was significantly different between prediabetes and NOD groups both before and after pravastatin treatment (0% versus 37.5%, P = 0.001), but pravastatin treatment did not affect the prevalence of IR in the prediabetes or NOD group. Fasting glucose level was not significantly different before and after pravastatin treatment in prediabetes (106.8 ± 6.4 mg/dL versus 103.8 ± 8.4 mg/dL, P = 0.223) but was significantly different in the NOD group (171.5 ± 70.1 mg/dL versus 124.4 ± 26.7 mg/dL,P = 0.017).

 Conclusion

Pravastatin treatment did not affect IR or fasting glucose level in hyperglycemic patients. Therefore, we suggest pravastatin can be prescribed to hypercholesterolemic patients with hyperglycemia.

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Fasting insulin level, homeostasis model assessment of insulin resistance (HOMA-IR) and quantitative insulin sensitivity check index (QUICKI) before and after pravastatin treatment. Black, new onset diabetes mellitus; Gray, prediabetes.

Baseline characteristics

  Total Prediabetes New onset diabetes P-value
Number 40 24 16  
Age (years) 58.2 ± 8.2 59.8 ± 9.0 55.8 ± 6.6 0.28
Male gender (%) 20 (50.0) 12 (50.0) 8 (50.0) 1.0
Height (m) 1.6 ± 0.05 1.6 ± 0.05 1.6 ± 0.03 0.16
Weight (kg) 60.6 ± 8.9 60.8 ± 9.3 60.9 ± 8.5 1.0
BMI (kg/m2) 24.1 ± 2.5 24.4 ± 2.7 24.3 ± 2.9 0.48
Hypertension (Hx, %) 12 (30.0) 7 (29.2) 5 (31.3) 0.89
Hypertension duration (years) 0 (2∼15) 0 (3∼15) 0 (2∼5) 0.116
HbA1c (%) 7.0 ± 2.0 5.9 ± 0.4 8.8 ± 2.4 0.001

Values are presented as number only, mean ± standard deviation, number (%), or median (range). P-value is for the comparison of the prediabetes group to the new onset diabetes group. BMI, body mass index.

The comparison of lipid profile, HOMA-IR and QUICKI before and after pravastatin treatment

Variables Total Prediabetes New onset diabetes
Before After P-value Before After P-value Before After P-value
Insulin (μU/mL) 6.03 ± 5.03 6.81 ± 5.72 0.575 4.41 ± 2.38 4.31 ± 2.10b 0.57 8.07 ± 6.71 10.16 ± 7.23b 0.098
C-peptide (ng/mL) 1.68 ± 0.89 1.96 ± 1.29 0.247 1.34 ± 0.53a 1.35 ± 0.64b 0.937 2.2 ± 1.1a 2.9 ± 1.5b 0.093
Total cholesterol (mg/dL) 229.6 ± 37.8 171.8 ± 25.5 0.000 228.1 ± 33.7 174.4 ± 23.5 0.002 231.8 ± 45.6 167.8 ± 29.4 0.025
LDL cholesterol (mg/dL) 148.7 ± 22.7 100.7 ± 21.9 0.000 150.3 ± 22.1 102.5 ± 18.4 0.002 146.3 ± 24.9 98.0 ± 27.4 0.017
HDL cholesterol (mg/dL) 59.9 ± 13.1 56.7 ± 12.0 0.243 58.9 ± 15.3 58.1 ± 14.0 0.695 61.4 ± 9.4 54.5 ± 8.5 0.176
Triglycerides (mg/dL) 127.7 ± 63.3 108.2 ± 62.4 0.040 111.2 ± 55.0a 102.3 ± 69.2 0.131 152.4 ± 70.4a 117.0 ± 53.7 0.093
Fasting glucose (mg/dL) 132.7 ± 53.8 112.0 ± 20.3 0.007 106.8 ± 6.4a 103.8 ± 8.4b 0.223 171.5 ± 70.1a 124.4 ± 26.7b 0.017
HOMA-IR 1.88 ± 1.54 1.96 ± 1.80 0.881 1.21 ± 0.67a 1.14 ± 0.54b 0.647 2.88 ± 1.93a 3.19 ± 2.31b 0.301
QUICKI 0.364 ± 0.04 0.36 ± 0.04 0.732 0.38 ± 0.03a 0.38 ± 0.03b 0.927 0.33 ± 0.03a 0.34 ± 0.04b 0.836

Values are presented as mean ± standard deviation. HOMA-IR, homeostasis model assessment of insulin resistance; QUICKI, quantitative insulin sensitivity check index; LDL, low-density lipoprotein; HDL, high-density lipoprotein.

P < 0.05 for comparison between prediabetes and new onset diabetes groups before pravastatin treatment.

P < 0.05 for comparison between prediabetes and new onset diabetes groups after pravastatin treatment.