Abstract P219: Lesser LDL Drop on Statins Predicts Greater Glycemic Rise in Women
Background: Statins elevate glucose (glc) in some people, but effects vary. Age & metabolic syndrome precursors were previously shown to significantly predict glc rise on statins (vs placebo) in men but not women. Better understanding of predictors in women is needed. Higher baseline LDL and lesser drop in LDL on statins was previously linked to more muscle symptoms on statins - postulated to arise from LDL upregulation for antioxidant transport in prooxidant settings - which might also lead to glc elevation.
Goal: To assess the relation of LDL (baseline and change-on-statins) to glc change (Δglc) in women.
Method: 324 postmenopausal women, without known diabetes or CVD, with fasting glc ≤142mg/dL, LDL 115-190 mg/dL, underwent (sex-stratified, double-blind) randomization to pravastatin 40mg, simvastatin 20mg or placebo for 6 months. 203 were age<65. Regression assessed prediction of Δglc by statin-vs-placebo, baseline and ΔLDL, adjusted for baseline-glc§. Analysis was repeated, stratified by treatment arm (omitting the treatment term).
Results: Less LDL drop (& higher baseline LDL) predicted greater glc rise, in models adjusting for statin-vs-placebo (Table, A); and in stratified analyses on each statin, but not on placebo (Table, C). Randomized effects appeared stronger in age <65 (Table, B).
Discussion: Higher baseline LDL and lesser LDL drop on statins previously predicted risk of statin muscle AEs, previously shown to relate to prooxidant statin effects. Prooxidant effects - known to predict glc rise - have been linked to higher LDL, which may reflect upregulation as LDL serves critical antioxidant transport functions. Certain predictors of glc rise due to statins were previously shown to operate selectively in men, moreso in elderly. The present findings complement those, identifying predictors of glc rise that operate preferentially in women and perhaps nonelderly. Findings add to understanding of predictors of glc rise on statins, and underscore need to consider effect modification by age and sex.
Author Disclosures: B.A. Golomb: None. A.K. Bui: None.
- © 2015 by American Heart Association, Inc.