title: HMG CoA reductase inhibitor treatment induces dysglycemia in renal allograft recipients.
abstract: BACKGROUND
  Dysglycemia and dyslipidemia are important metabolic complications of organ transplantation. Statins are widely used to control dyslipidemia; however, long-term use of statins is related to diabetes mellitus (DM) and impaired fasting glucose (IFG). The aim of this study was to evaluate the influence of statins on the development of dysglycemia (IFG and/or DM) in renal allograft recipients.
  
  
  METHODS
  A total of 394 patients without previously known DM or IFG who underwent kidney transplantation were enrolled. Patients were grouped into the two groups according to the use of statin (control, n=149; statin, n=245). The major statins used were fluvastatin (80 mg/d, n=134) and atorvastatin (20 mg/d, n=111). We compared the incidence of IFG or DM during the follow-up period.
  
  
  RESULTS
  The incidence of IFG was higher in the statin group than that in the control group (28.6% vs. 8.7%, P<0.001). The incidence of dysglycemia was significantly higher in the statin group (40.0% vs. 15.4%, P=0.001). Time to development of dysglycemia after transplantation was shorter in the statin group than in the control group (38.8±29.7 vs. 47.2±23.3 months, P=0.002). Statin use was associated with an increased risk for dysglycemia after adjustment for age, sex, body mass index, hypertension, cholesterol levels, hepatitis C infection, and type of immunosuppressant (hazard ratio=3.08, 95% confidence interval=1.91-4.98). The dysglycemic effect was more profound in the patients who used atorvastatin than in those who used fluvastatin (hazard ratio=2.21, 95% confidence interval=1.02-4.76).
  
  
  CONCLUSIONS
  Statin treatment is associated with an elevation in fasting plasma glucose and in the development of dysglycemia in renal allograft recipients.
authors.affiliation: 1 Division of Endocrinology and Metabolism, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea. 2 Brain Korea 21 Project for Medical Science, Yonsei University College of Medicine, Seoul, Korea. 3 Institute of Endocrine Research, Yonsei University College of Medicine, Seoul, Korea. 4 Department of Pharmacology, Yonsei University College of Medicine, Seoul, Korea. 5 Department of Transplantation Surgery Yonsei University Health System, Seoul, Korea. 6 Address correspondence to: Eun Seok Kang, M.D., Ph.D., Department of Internal Medicine, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-Ku, Seoul, 120-752, Korea.
authors.forename: Eun Yeong
authors.initials: EY
authors.lastname: Choe
authors.forename: Hye Jin
authors.initials: HJ
authors.lastname: Wang
authors.forename: Obin
authors.initials: O
authors.lastname: Kwon
authors.forename: Yongin
authors.initials: Y
authors.lastname: Cho
authors.forename: Kyu Ha
authors.initials: KH
authors.lastname: Huh
authors.forename: Myoung Soo
authors.initials: MS
authors.lastname: Kim
authors.forename: Yu Seun
authors.initials: YS
authors.lastname: Kim
authors.forename: Chul Woo
authors.initials: CW
authors.lastname: Ahn
authors.forename: Bong Soo
authors.initials: BS
authors.lastname: Cha
authors.forename: Hyun Chul
authors.initials: HC
authors.lastname: Lee
authors.forename: Eun Seok
authors.initials: ES
authors.lastname: Kang
mesh_terms: D000328:Adult; D000924:Anticholesteremic Agents / Q000009:adverse effects; D000069059:Atorvastatin; D001786:Blood Glucose / Q000096:biosynthesis*; D048909:Diabetes Complications / Q000175:diagnosis; D003920:Diabetes Mellitus / Q000175:diagnosis; D050171:Dyslipidemias / Q000139:chemically induced; D005215:Fasting; D005229:Fatty Acids, Monounsaturated / Q000009:adverse effects; D005260:Female; D000077340:Fluvastatin; D005500:Follow-Up Studies; D005919:Glomerular Filtration Rate; D006538:Heptanoic Acids / Q000009:adverse effects; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000009:adverse effects*; D006943:Hyperglycemia / Q000150:complications / Q000209:etiology*; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D015994:Incidence; D007211:Indoles / Q000009:adverse effects; D016030:Kidney Transplantation / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011758:Pyrroles / Q000009:adverse effects; D051437:Renal Insufficiency / Q000150:complications* / Q000628:therapy
chemical_list: D000924:Anticholesteremic Agents; D001786:Blood Glucose; D005229:Fatty Acids, Monounsaturated; D006538:Heptanoic Acids; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D007166:Immunosuppressive Agents; D007211:Indoles; D011758:Pyrroles; D000077340:Fluvastatin; D000069059:Atorvastatin