Gannagé-Yared Marie-Hélène, Azar Rabih R, Amm-Azar Mireille, Khalifé Simon, Germanos-Haddad Myrna, Neemtallah Ramy, Halaby Georges
Division of Endocrinology, Hôtel-Dieu de France Hospital, Beirut, Lebanon.
Metabolism. 2005 Jul;54(7):947-51. doi: 10.1016/j.metabol.2005.02.011.
The effect of statins on insulin resistance is controversial and poorly studied in nondiabetic subjects. In addition, the effect of statins on leptin and adiponectin has never been studied.
Forty healthy nondiabetic volunteers (22 men and 18 women) aged 28 to 72 were randomized either to placebo or pravastatin 40 mg daily for a 12-week period. Insulin resistance, assessed using the Quantitative Insulin Sensitivity Check Index (QUICKI), as well as serum leptin and adiponectin levels, was measured at baseline and at the end of therapy.
Pravastatin treatment decreased total cholesterol, low-density lipoprotein cholesterol, and triglycerides levels by 24%, 32%, and 14%, respectively ( P < .05 for all), but did not affect glucose and insulin levels, the (QUICKI) index, and adiponectin and leptin levels. When stratification was performed according to QUICKI index or sex, no significant differences were observed in the prevalues and postvalues of leptin, adiponectin, or QUICKI index in the pravastatin group. Adiponectin, leptin, and QUICKI index were statistically higher in women than in men ( P < .001 for both variables). Adiponectin was negatively correlated with body mass index (BMI; r = -0.39, P < .05) and positively correlated with the QUICKI index ( r = 0.54, P < .001) and with high-density lipoprotein cholesterol ( r = 0.50, P < .01). The relation between adiponectin and QUICKI index remained significant after adjustment for sex and BMI ( P = .005 and P = .007, respectively). Leptin was only related to BMI ( r = 0.57, P < .001) and to sex ( P < .001) with no significant correlations with lipid parameters or QUICKI index. Both sex and BMI are independent predictors of leptin ( P < .001 and P < .001).
A 12-week treatment with pravastatin 40 mg/d does not change the QUICKI index and leptin and adiponectin levels in healthy volunteers. In addition, our results emphasize the importance of sex and BMI in the determination of both adiponectin and leptin. Adiponectin was also related to QUICKI index, whereas this relation was not found with leptin.
他汀类药物对胰岛素抵抗的影响存在争议,且在非糖尿病患者中研究较少。此外,他汀类药物对瘦素和脂联素的影响尚未得到研究。
40名年龄在28至72岁之间的健康非糖尿病志愿者(22名男性和18名女性)被随机分为两组,一组服用安慰剂,另一组每天服用40毫克普伐他汀,为期12周。在基线和治疗结束时测量胰岛素抵抗(使用定量胰岛素敏感性检查指数(QUICKI)评估)以及血清瘦素和脂联素水平。
普伐他汀治疗使总胆固醇、低密度脂蛋白胆固醇和甘油三酯水平分别降低了24%、32%和14%(所有P值均<0.05),但未影响血糖和胰岛素水平、QUICKI指数以及脂联素和瘦素水平。根据QUICKI指数或性别进行分层时,普伐他汀组中瘦素、脂联素或QUICKI指数的治疗前和治疗后值均无显著差异。女性的脂联素、瘦素和QUICKI指数在统计学上高于男性(两个变量的P值均<0.001)。脂联素与体重指数(BMI;r = -0.39,P < 0.05)呈负相关,与QUICKI指数(r = 0.54,P < 0.001)以及高密度脂蛋白胆固醇(r = 0.50,P < 0.01)呈正相关。在对性别和BMI进行调整后,脂联素与QUICKI指数之间的关系仍然显著(分别为P = 0.005和P = 0.007)。瘦素仅与BMI(r = 0.57,P < 0.001)和性别(P < 0.001)相关,与血脂参数或QUICKI指数无显著相关性。性别和BMI都是瘦素的独立预测因素(P < 0.001和P < 0.001)。
每天服用40毫克普伐他汀进行12周治疗不会改变健康志愿者的QUICKI指数以及瘦素和脂联素水平。此外,我们的结果强调了性别和BMI在确定脂联素和瘦素方面的重要性。脂联素也与QUICKI指数相关,而瘦素与QUICKI指数无此关系。