Endocrine Abstracts

The diabetogenic risk associated with statin therapy is higher in patients with pre-existing risk factors, such as metabolic syndrome (MS).

Objective: To assess changes in lipid and glycemic profile in dyslipidemic subjects with MS after statin therapy.

Methods: Observational, retrospective, multi-center study, conducted in 40 endocrinology Spanish hospitals. Each endocrinologist included the first 10 patients >18 years with MS, HDL-C<40 mg/dl in men and <50 mg/dl in women and two or more MS risk factors according to NCEP-ATP III criteria, treated with statins for at least 12 weeks before their inclusion, and had signed informed consent. Demographic variables, medical history, diabetic complications, anthropometric data and analytical and therapeutic profiles were collected before and after starting statin therapy. ADA objectives for lipid and glycemic control, student t test for paired data or the Wilcoxon sign tests for quantitative variables, and McNemar test or Fisher’s exact test for qualitative variables were used. A P<0.05 was significant.

Results: A total of 388 patients were enrolled, of them 345 were evaluated; 53.9% were men, age was 60.9±9.3 years, 89.9% had abdominal obesity, 88.7% hypertension, 88.4% fasting glucose (FG)≥110 mg/dl, 77.7% triglycerides(TGs) ≥150 mg/dl and 100% HDL-C<40 mg/dl in men and <50 mg/dl in women. After statin therapy, there was a decrease in total cholesterol, TGs, LDL-C, HbA1C and FG, and an increase in HDL-C and in the percentage of patients achieving the ADA objectives (P<0.001 for all). Multivariate analysis showed a greater increase of HDL-C with pitavastatin 18.4% (vs atorvastatin 7.4%; P=0.0094, and vs simvastatin 9.6%; P<0.0001), and univariate analysis a reduction on the percentage of change on FG (4.8±20.5%; P<0.0161) after treatment with pitavastatin

Conclusion: In the MS patients studied, glucidic and lipid parameters and the percentage of patients achieving the ADA objectives improved after statin therapy. Pitavastatin could have better cardiovascular benefit due to the greater increase in HDL-C.