Could changes in adiponectin drive the effect of statins on the risk of new-onset diabetes? The case of pitavastatin

Lorenzo Arnaboldi, Alberto Corsini

Research output: Contribution to journalArticle

Abstract

Statins represent the elective lipid-lowering strategy in hyperlipidemic and high cardiovascular-risk patients. Despite excellent safety and tolerability, reversible muscle-related and dose-dependent adverse events may decrease a patient's compliance. Large meta-analyses, post-hoc and genetic studies showed that statins might increase the risk of new-onset diabetes (NOD), particularly in insulin-resistant, obese, old patients. Race, gender, concomitant medication, dose and treatment duration may also contribute to this effect. Based on this evidence, to warn against the possibility of statin-induced NOD or worsening glycemic control in patients with already established diabetes, FDA and EMA changed the labels of all the available statins in the USA and Europe. Recent meta-analyses and retrospective studies demonstrated that statins' diabetogenicity is a dose-related class effect, but the mechanism(s) is not understood. Among statins, only pravastatin and pitavastatin do not deteriorate glycemic parameters in patients with and without type 2 diabetes mellitus. Interestingly, available data, obtained in small-scale, retrospective or single-center clinical studies, document that pitavastatin, while ameliorating lipid profile, seems protective against NOD. Beyond differences in pharmacokinetics between pitavastatin and the other statins (higher oral bioavailability, lower hepatic uptake), its consistent increases in plasma adiponectin documented in clinical studies may be causally connected with its effect on glucose metabolism. Adiponectin is a protein with antiatherosclerotic, anti-inflammatory and antidiabetogenic properties exerted on liver, skeletal muscle, adipose tissue and pancreatic beta cells. Further studies are required to confirm this unique property of pitavastatin and to understand the mechanism(s) leading to this effect.

Original languageEnglish
Pages (from-to)1-27
Number of pages27
JournalAtherosclerosis Supplements
Volume16
DOIs
Publication statusPublished - Jan 1 2015

Fingerprint

Hydroxymethylglutaryl-CoA Reductase Inhibitors
Adiponectin
Meta-Analysis
Lipids
Pravastatin
Muscles
Liver
Insulin-Secreting Cells
Patient Compliance
Drive
pitavastatin
Type 2 Diabetes Mellitus
Biological Availability
Adipose Tissue
Skeletal Muscle
Anti-Inflammatory Agents
Retrospective Studies
Pharmacokinetics
Insulin
Safety

Keywords

  • Adiponectin
  • Insulin sensitivity
  • Pitavastatin
  • Statins
  • Type 2 diabetes mellitus (T2DM)

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Internal Medicine
  • Medicine(all)

Cite this

Could changes in adiponectin drive the effect of statins on the risk of new-onset diabetes? The case of pitavastatin. / Arnaboldi, Lorenzo; Corsini, Alberto.

In: Atherosclerosis Supplements, Vol. 16, 01.01.2015, p. 1-27.

Research output: Contribution to journalArticle

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