title: The good and bad effects of statins on insulin sensitivity and secretion.
abstract: OBJECTIVE
  Statins are the main lipid-lowering treatment in both primary and secondary prevention populations. Whether statins deteriorates glycemic control, predisposing to the onset of diabetes mellitus has been a matter of recent concern. Statins may accelerate progression to diabetes via molecular mechanisms that impact insulin sensitivity and secretion. In this review, we debate the relative effect of statins in driving insulin resistance and the impairment of insulin secretion.
  
  
  METHODS
  Narrative overview of the literature synthesizing the findings of literature was retrieved from searches of computerized databases, hand searches, and authoritative texts employing the key words "Statins", "Randomized Clinical Trial", "Insulin sensitivity", "Insulin resistance", "Insulin Secretion", "Diabetes Mellitus" alone and/or in combination.
  
  
  RESULTS
  The weight of clinical evidence suggests a worsening effect of statins on insulin resistance and secretion, anyway basic science studies did not find a clear molecular explanation, providing conflicting evidence regarding both the beneficial and the adverse effects of statin therapy on insulin sensitivity.
  
  
  CONCLUSIONS
  Although most of the clinical studies suggest a worsening of insulin resistance and secretion, the cardiovascular benefits of statin therapy outweigh the risk of developing insulin resistance, thus the data suggest the need to treat dyslipidemia and to make patients aware of the possible risk of developing type 2 diabetes or, if they already are diabetic, of worsening their metabolic control.
authors.affiliation: Department of Clinical Medicine and Surgery, University "Federico II" , Naples , Italy .
authors.forename: Giovanna
authors.initials: G
authors.lastname: Muscogiuri
authors.forename: Gerardo
authors.initials: G
authors.lastname: Sarno
authors.forename: Amalia
authors.initials: A
authors.lastname: Gastaldelli
authors.forename: Silvia
authors.initials: S
authors.lastname: Savastano
authors.forename: Antonio
authors.initials: A
authors.lastname: Ascione
authors.forename: Annamaria
authors.initials: A
authors.lastname: Colao
authors.forename: Francesco
authors.initials: F
authors.lastname: Orio
mesh_terms: D000818:Animals; D003924:Diabetes Mellitus, Type 2 / Q000139:chemically induced* / Q000453:epidemiology; D050171:Dyslipidemias / Q000188:drug therapy / Q000378:metabolism; D019317:Evidence-Based Medicine; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000009:adverse effects* / Q000494:pharmacology / Q000627:therapeutic use; D007328:Insulin / Q000378:metabolism*; D007333:Insulin Resistance; D000078790:Insulin Secretion; D050417:Insulin-Secreting Cells / Q000187:drug effects* / Q000378:metabolism; D008099:Liver / Q000187:drug effects / Q000201:enzymology / Q000378:metabolism; D010353:Patient Education as Topic; D016032:Randomized Controlled Trials as Topic; D012306:Risk; D018570:Risk Assessment
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D007328:Insulin
keywords: Cardiovascular disease; dyslipidemia; insulin resistance; insulin secretion; statins; type 2 diabetes