Effects Of Resuvastatin And Atorvastatin On Insulin Sensitivity And Neuregulin4

Objective To observe the effects of resuvastatin and atorvastatin on the level of fasting blood glucose,fasting insulin,glycosylated hemoglobin,blood lipids and serum neuregulin4(Nrg4)levels in non-diabetic patiens with dislipidemia,the changes of insulin resistance index(HOMA-IR)and atherosclerosis index(AI)were calculated.Compare the effects of different statins on insulin sensitivity,atherosclerosis and serum Nrg4 level.Method 60 non-diabetic patients with dislipidemia were divided into two groups.30 cases were treated by resuvastatin(10mg per night),the other group was treated by at orvastatin(20mg per night).The two groups all were treated for 8 weeks,change of fasting blood glucose,fasting insulin,glycosylated hemoglobin,serum Nrg4 level and blood lipid,hepatic function,renal function were measured,the change of insulin resistance index and atherosclerosis index were calculated.Result(1)After the treatment of resuvastatin,the glycosylated hemoglobin(HbA1c),fasting blood glucose(FBG),high-density lipoprotein(HDL),the insulin resistance index and serum Nrg4 were higher than before treatment(P<0.05),the triglyceride(TG),total cholesterol(TC),low-density lipoprotein(LDL)and atherosclerosis index were all lower than before(P<0.05).There was no statistical difference in fasting insulin during treatment(P?0.05).After the treatment of resuvastatin,the alanine aminot ransferase(ALT),aspartate aminotransferase(AST),serum creatinine(Scr)were higher than before treatment(P<0.05).There were no statistical difference in uric nitrogen(BUN)and creatine kinase(CK)during treatment(P?0.05).After the treatment of atorvastatin,the glycosylated hemoglobin(HbA1c),fasting blood glucose(FBG),high-density lipoprotein(HDL),the insulin resistance index and serum Nrg4 were higher than before treatment(P<0.05),the triglyceride(TG),total cholesterol(TC),low-density lipoprotein(LDL)and atherosclerosis index were all lower than before(P<0.05).There were no statistical difference in fasting insulin,alanine aminotransferase(ALT),aspartate aminotransferase(AST),serum creatinine(Scr),uric nitrogen(BUN)and creatine kinase(CK)during treatment.(2)Compare with the group of atorvastatin,the reduction of triglyceride,total cholesterol,low-density cholesteroland atherosclerosis index were more significant in the resuvastatin after the treatment of 8 weeks(P<0.05).Compare with the group of resuvastatin,the elevation of fasting blood glucose,glycosylated hemoglobin and insulin resistance index were more significant in the group of atorvastatin after the treatment of 8 weeks(P<0.05).The difference of Nrg4 during treatment was not statistically significant between the two group(P?0.05).(3)The correlation analysis revealed that the levels of TC(r=-0.27,P<0.05)and AI(r=-0.661,P<0.05)were correlated with Nrg4,the decrease of AI(?=-0.576,P<0.05)was independently impact factor of Nrg4 by multiple stepwise regression analysis.Conclusion Resuvastatin and atorvastatin can increase blood glucose,increase insulin resistance,and the effect of atorvastatin on blood glucose and insulin resistance is more obvious.The effect of statins on increasing insulin resistance had no correlation with Nrg4 in serum.Serum Nrg4 was negatively correlated with atherosclerosis index.Significance This prospective study confirmed that statins(resuvastatin and atorvastatin)can increase blood glucose,increase insulin resistance.Hyperlipidemia patients,especilly the combination of hyperlipidemia patients with abnormal glucose tolerance who in application of statins,need to monitor blood glucose.Compare with atorvastatin,it's better to choose resuvastatin which has a relatively small effect on blood glucose.The study also confirmed that statins can reduce atherosclerosis index.Atherosclerosis index was negatively correlated with Nrg4 in serum.