Abstract 3947: Pravastatin Improved Glucose Metabolism Associated with Increasing Plasma Adiponectin in Patients with Impaired Glucose Tolerance and Coronary Artery Disease
Background Several randomized clinical trials have shown reduced incidence of type-2 diabetes in patients treated with pravastatin, a 3-hydroxy-3-methylglutaryl coenzyme-A reductase inhibitor. Many coronary artery disease (CAD) patients with hypercholesterolemia also have impaired glucose metabolism. Adiponectin, an adipocyte-derived secreted protein, can exhibit beneficial effects on insulin resistance with anti-atherogenic property. We hypothesized that pravastatin could improve glucose tolerance by increasing adiponectin levels in CAD patients.
Methods This study was a prospective, single-center, randomized, open-labeled trial consisted of 40 CAD patients with impaired glucose tolerance (IGT) assessed by oral glucose tolerance test (OGTT). Patients were randomized to receive pravastatin (n=20) or no lipid-lowering drugs (control group, n=20) for 6 months, after which OGTT was repeated and adiponectin levels were measured.
Results Pravastatin-treatment significantly decreased levels of total cholesterol (16%), low-density lipoprotein cholesterol (23%), and high sensitivity C-reactive protein (37%) compared with baseline (p<0.01). At 2-hour in OGTT, pravastatin significantly improved hyperglycemia (-23 mg/dL, p<0.01) and hyperinsulinemia (-20 μU/mL, p=0.01). Area under the curve of glucose and insulin during OGTT were significantly reduced pravastatin group (glucose; −10% and insulin; −18%). Pravastatin-treatment significantly elevated plasma adiponectin levels (35%, p<0.01) but not in control group. The glucose reduction values at 2-hour in OGTT were significantly associated with increased levels of adiponectin (r=-0.462, p=0.003). Pravastatin-treatment is an independent predictor for improvement of post-loaded hyperglycemia (odds ratio; 5.7; 95% confidence interval 1.3–25.6; p=0.02) and achieved beneficial conversion from IGT to normal glucose tolerance (40%, p=0.03).
Conclusions Pravastatin exhibits beneficial effects on glucose metabolism especially in the postprandial state associated with increase in plasma adiponectin levels in CAD patients with IGT. Pravastatin may provide an advantageous therapeutic strategy to improve metabolic disorders including both of cholesterol and glucose.