title: Comparison of the effects of simvastatin vs. rosuvastatin vs. simvastatin/ezetimibe on parameters of insulin resistance.
abstract: BACKGROUND
  Statin treatment may be associated with adverse effects on glucose metabolism. Whether this is a class effect is not known. In contrast, ezetimibe monotherapy may beneficially affect insulin sensitivity.
  
  
  OBJECTIVE
  The aim of this study was to compare the effects of three different regimens of equivalent low-density lipoprotein cholesterol (LDL-C) lowering capacity on glucose metabolism.
  
  
  METHODS
  A total of 153 patients (56 men), who had not achieved the LDL-C goal recommended by the National Cholesterol Education Program Adult Treatment Panel III (NCEP-ATP III) despite a 3-month dietary and lifestyle intervention, were randomly allocated to receive open-label simvastatin 40 mg or rosuvastatin 10 mg or simvastatin/ezetimibe 10/10 mg for 12 weeks. The primary end point was changes in homeostasis model assessment of insulin resistance (HOMA-IR). Secondary endpoints consisted of changes in fasting insulin levels, fasting plasma glucose (FPG), glycosylated haemoglobin (HbA(1c) ), the HOMA of β-cell function (HOMA-B) (a marker of basal insulin secretion by pancreatic β-cells), LDL-C and high sensitivity C reactive protein (hsCRP).
  
  
  RESULTS
  At week 12, all three treatment regimens were associated with significant increases in HOMA-IR and fasting insulin levels (p < 0.05 compared with baseline). No significant difference was observed between groups. No change in FPG, HbA(1c) and HOMA-B levels compared with baseline were noted in any of the three treatment groups. Changes in serum lipids and hsCRP were similar across groups.
  
  
  CONCLUSIONS
  To the extent that simvastatin 40 mg, rosuvastatin 10 mg and simvastatin/ezetimibe 10/10 mg are associated with adverse effects on insulin resistance, they appear to be of the same magnitude.
authors: Department of Internal Medicine, Medical School, University of Ioannina, Ioannina, Greece.
authors: E
authors: E
authors: Moutzouri
authors: E
authors: E
authors: Liberopoulos
authors: D P
authors: DP
authors: Mikhailidis
authors: M S
authors: MS
authors: Kostapanos
authors: A A
authors: AA
authors: Kei
authors: H
authors: H
authors: Milionis
authors: M
authors: M
authors: Elisaf
mesh_terms: D000368:Aged; D001384:Azetidines / Q000008:administration & dosage / Q000009:adverse effects*; D001786:Blood Glucose / Q000187:drug effects / Q000378:metabolism; D015992:Body Mass Index; D008078:Cholesterol, LDL / Q000378:metabolism; D004338:Drug Combinations; D000069438:Ezetimibe; D005215:Fasting / Q000097:blood; D005260:Female; D005464:Fluorobenzenes / Q000008:administration & dosage / Q000009:adverse effects*; D006706:Homeostasis / Q000187:drug effects; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000008:administration & dosage / Q000009:adverse effects*; D006937:Hypercholesterolemia / Q000188:drug therapy*; D007333:Insulin Resistance / Q000502:physiology*; D008297:Male; D055118:Medication Adherence; D008875:Middle Aged; D011743:Pyrimidines / Q000008:administration & dosage / Q000009:adverse effects*; D000068718:Rosuvastatin Calcium; D019821:Simvastatin / Q000008:administration & dosage / Q000009:adverse effects*; D013449:Sulfonamides / Q000008:administration & dosage / Q000009:adverse effects*; D016896:Treatment Outcome
chemical_list: D001384:Azetidines; D001786:Blood Glucose; D008078:Cholesterol, LDL; D004338:Drug Combinations; D005464:Fluorobenzenes; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D011743:Pyrimidines; D013449:Sulfonamides; D000068718:Rosuvastatin Calcium; D019821:Simvastatin; D000069438:Ezetimibe