RENAL-FUNCTION AND INSULIN SENSITIVITY DURING SIMVASTATIN TREATMENT IN TYPE-2 (NON-INSULIN-DEPENDENT) DIABETIC-PATIENTS WITH MICROALBUMINURIA

Citation
S. Nielsen et al., RENAL-FUNCTION AND INSULIN SENSITIVITY DURING SIMVASTATIN TREATMENT IN TYPE-2 (NON-INSULIN-DEPENDENT) DIABETIC-PATIENTS WITH MICROALBUMINURIA, Diabetologia, 36(10), 1993, pp. 1079-1086
Citations number
64
Categorie Soggetti
Endocrynology & Metabolism","Medicine, General & Internal
Journal title
ISSN journal
0012186X
Volume
36
Issue
10
Year of publication
1993
Pages
1079 - 1086
Database
ISI
SICI code
0012-186X(1993)36:10<1079:RAISDS>2.0.ZU;2-D
Abstract
The effect of simvastatin (10-20 mg/day) on kidney function, urinary a lbumin excretion rate and insulin sensitivity was evaluated in 18 Type 2 (non-insulin-dependent) diabetic patients with microalbuminuria and moderate hypercholesterolaemia (total cholesterol greater-than-or-equ al-to 5.5 mmol.l-1). In a double-blind, randomized and placebo-control led design treatment with simvastatin (n = 8) for 36 weeks significant ly reduced total cholesterol (6.7 +/- 0.3 vs 5.1 mmol.l-1 (p < 0.01)), LDL-cholesterol (4.4 +/- 0.3 vs 2.9 +/- 0.2 mmol.l-1 (p < 0.01)) and apolipoprotein B (1.05 +/- 0.04 vs 0.77 +/- 0.02 mmol.l-1 (p < 0.01)) levels as compared to placebo (n = 10). Both glomerular filtration rat e (mean +/- SEM) (simvastatin: 96.6 +/- 8.0 vs 96.0 +/- 5.7 ml.min-1.1 .73 m-2, placebo: 97.1 +/- 6.7 vs 88.8 +/- 6.0 ml.min-1.1.73 m-2)(NS) and urinary albumin excretion rate (geometric mean x/divided-by antilo g SEM) (simvastatin: 18.4 x/divided-by 1.3 vs 16.2 x/divided-by 1.2 mu g.min-1, placebo 33.1 x/divided-by 1.3 vs 42.7 x/divided-by 1.3 mug.mi n-1)(NS) were unchanged during the study. A euglycaemic hyperinsulinae mic clamp was performed at baseline and after 18 weeks in seven simvas tatin- and nine placebo-treated patients. Isotopically determined basa l and insulin-stimulated glucose disposal was similarly reduced before and during therapy in both the simvastatin (2.0 +/- 0.1 vs 1.9 +/- 0. 1 (NS) and 3.1 +/- 0.6 vs 3.1 +/- 0.7 mg-kg-l.min-1 (NS)) and the plac ebo group (1.9 +/- 0.1 vs 1.8 +/- 0.1 (NS) and 4.1 +/- 0.6 vs 3.8 +/- 0.2 mg.kg-1 .min-1 (NS)). No difference was observed in glucose storag e or glucose and lipid oxidation before and after treatment. Further, the suppression of hepatic glucose production during hyperinsulinaemia was not influenced by simvastatin (-0.7 +/- 0.8 vs -0.7 +/- 0.5 mg.kg -1.min-1 (NS)). In conclusion, despite marked improvement in the dysli pidaemia simvastatin had no impact on kidney function or urinary album in excretion rate and did not reduce insulin resistance in these micro albuminuric and moderately hypercholesterolaemic Type 2 diabetic patie nts.