Effects Of Statins On Blood Glucose And FGF21 In Patients With Hypercholesterolemia

Objective:To observe the effects of atorvastatin and resuvastatin on the level of fasting blood glucose,fasting insulin,glycosylated hemoglobin,blood lipids and fibroblast growth factor 21(FGF21)levels in non-diabetic patiens with hypercholesterolemia.To compare the effects of different statins on fasting blood glucose and serum FGF21 levels in patients with hypercholesterolemia.Method:60 non-diabetic patients with hypercholesterolemia were divided into two groups.30 cases were treated by atorvastatin(20mg per night),the other group wastreated byr esuvastatin(10mg per night).The two groups all were treated for 12 weeks,change of fasting blood glucose,fasting insulin,glycosylated hemoglobin,serum FGF21 level a nd blood lipid,hepatic function,renal function were measured,the change of insulinr esistance index was calculated.Result:(1)After the treatment of atorvastatin,the triglyceride(TG),total cholesterol(TC),low-density lipoprotein(LDL),fasting in insulin(FINS)and FGF21 were all lower than before(P<0.05).The alanine aminotransferase(ALT),aspartate aminotransf erase(AST),fasting blood glucose(FBG),high-density lipoprotein(HDL)and the glycosylated hemoglobin(HbA1c)were all higher than before treatment(P<0.05).There were no stati stical difference in uric nitrogen(BUN),serum creatinine(Scr),creatine kinase(CK)and the insulin resistance index after the treatment(P?0.05).After the treatment of resuvastatin,the triglyceride(TG),total cholesterol(TC),low-density lipoprotein(LDL)and FGF21 were all lower than before(P < 0.05),the glycosylated hemoglobin(HbA1c),fasting blood glucose(FBG),high-density lipoprotein(HDL)and the insulin resistance index,serum creatinine(Scr)were higher than before treatment(P <0.05).There were no statistical difference in uric nitrogen(BUN)?creatine kinase(CK)?the alanine aminotransferase(AL T)and aspartate aminotransferase(AST)after the treatment(P?0.05).(2)Compare with the group of atorvastatin,the reduction of total cholesterol(TC)and low-density cholesterol(LDL)were more significant in the resuvastatin after the treatment of 12 weeks(P<0.05).Compare with the group of resuvastatin,the elevation of fasting blood glucosewas and the glycosylated hemoglobin were more significant in the group of atorvastatin after the treatment of 12 weeks(P < 0.05).The difference of FGF21 during treatment was not statistically significant between the two groups(P?0.05).(3)The correlation analysis revealed that the levels of TG(r = 0.420 P< 0.05),FINS(r = 0.311 P< 0.05)and HDL(r =-0.396 P< 0.05)were correlated with FGF21,the decrease of TG(?=0.499 P<0.05)was independently impact factor of FGF21 by multiple stepwise regression analysis.Conclusion:Atorvastatin and resuvastatin can increase blood glucose,the effect of ator vastatin on blood glucose is more obvious.Resuvastatin can increase insulin resistance,and atorvastatin can decrease insulin releasing.The effect of statins on blood glucose had no correlation with FGF21 in serum.Serum FGF21 was positively correlated with TG.Significance:This prospective study confirmed that statins(resuvastatin and atorvastatin)can increase blood glucose by reducing insulin secretion and increasing insulin resistance.Hyperlipidemia patients,especilly the combination of hyperlipidemia patients with high risk factors of diabetes 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 the level of FGF21.the serum of FGF21 was positively correlated with TG.