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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).
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Fig. 1.
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.
Table 1.
Baseline characteristics
Table 2.
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.
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