Prediction of basal glycaemia dynamics during treatment with 6-month lipid-lowering therapy in patients at high risk of cardiovascular disease

Background. A major meta-analysis has confirmed the ability of statins to exert both diabetogenic and hyperglycaemic effects. To date, practical recommendations for predicting glucose dynamics during lipid-lowering therapy have not been developed. Aims. Identify the combination of factors that can...

Descripción completa

Guardado en:

Detalles Bibliográficos
Autores principales:	Olga A. Koshelskaya, Anastasiya S. Sushkova, Olga A. Zhuravleva, Irina V. Vinnizkaya, Nataliya G. Brazovskaya, Elena S. Kravchenko, Tatyana E. Suslova, Rostislav S. Karpov
Formato:	article
Lenguaje:	EN RU
Publicado:	Endocrinology Research Centre 2017
Materias:	lipid-lowering therapy statins ezetimibe basal glycemia coronary artery disease diabetes mellitus Nutritional diseases. Deficiency diseases RC620-627
Acceso en línea:	https://doaj.org/article/b8e14caef19448168be1bfadedef02f8
Etiquetas:	Agregar Etiqueta Sin Etiquetas, Sea el primero en etiquetar este registro!

id	oai:doaj.org-article:b8e14caef19448168be1bfadedef02f8
record_format	dspace
spelling	oai:doaj.org-article:b8e14caef19448168be1bfadedef02f82021-11-14T09:00:21ZPrediction of basal glycaemia dynamics during treatment with 6-month lipid-lowering therapy in patients at high risk of cardiovascular disease2072-03512072-037810.14341/DM8633https://doaj.org/article/b8e14caef19448168be1bfadedef02f82017-12-01T00:00:00Zhttps://www.dia-endojournals.ru/jour/article/view/8633https://doaj.org/toc/2072-0351https://doaj.org/toc/2072-0378Background. A major meta-analysis has confirmed the ability of statins to exert both diabetogenic and hyperglycaemic effects. To date, practical recommendations for predicting glucose dynamics during lipid-lowering therapy have not been developed. Aims. Identify the combination of factors that can predict changes in basal glycaemia during 6-month lipid-lowering therapy in patients at high risk of cardiovascular disease. Methods. This study reports on 50 patients with diabetes or impaired glucose tolerance, and 18 patients with coronary artery disease without disorders of carbohydrate metabolism. Of note, 29 of the 50 diabetic or glucose intolerant patients had documented ischaemic heart disease (stable angina). Patients were randomised into three groups: Gr.1 (n=33, atorvastatin therapy), Gr.2 (n=17, atorvastatin in combination with ezetimibe) and Gr.3 (n=18, rosuvastatin therapy). After treatment for 24 weeks, we assessed lipid profile dynamics, metabolism of glucose/insulin and the HOMA-IR index. Multivariate analysis was then performed to identify factors that predicted increases in basal glycaemia. Results. All of the included patients completed 24 weeks of treatment (N=68). Lipid-lowering effect was significant in all three groups, and overall, target LDL cholesterol level was achieved in 50% of patients (n=34). In Gr.2, basal glucose level increased from 5.5(5.3–6.6) to 6.3(5.6–7.8) mmol/l (p=0.0014), which was accompanied by an increase in HOMA-IR (p=0.024). No significant change in basal glycaemia was observed in Grs.1 and 3. Moreover, an increase in the basal glycaemia was observed in 48.5% of patients in Gr.1, 70.6% in Gr.2 and 44.4% in Gr.3. Multivariate discriminant analysis across all patient groups revealed a canonical linear discriminant function that included the following factors: baseline basal glucose levels, total cholesterol levels, triglycerides and ratio of LDL/HDL cholesterol. Sensitivity and specificity of the model accounted for 75%; 51 out of the 68 cases were correctly classified when predicting the dynamics of basal glucose during lipid-lowering therapy. Conclusions. Our data demonstrate the ability to predict the dynamics of the basal glycaemia during lipid-lowering therapy. This may allow for a new way to identify patients at high risk of statin-related increases in glycaemia.Olga A. KoshelskayaAnastasiya S. SushkovaOlga A. ZhuravlevaIrina V. VinnizkayaNataliya G. BrazovskayaElena S. KravchenkoTatyana E. SuslovaRostislav S. KarpovEndocrinology Research Centrearticlelipid-lowering therapystatinsezetimibebasal glycemiacoronary artery diseasediabetes mellitusNutritional diseases. Deficiency diseasesRC620-627ENRUСахарный диабет, Vol 20, Iss 5, Pp 374-383 (2017)
institution	DOAJ
collection	DOAJ
language	EN RU
topic	lipid-lowering therapy statins ezetimibe basal glycemia coronary artery disease diabetes mellitus Nutritional diseases. Deficiency diseases RC620-627
spellingShingle	lipid-lowering therapy statins ezetimibe basal glycemia coronary artery disease diabetes mellitus Nutritional diseases. Deficiency diseases RC620-627 Olga A. Koshelskaya Anastasiya S. Sushkova Olga A. Zhuravleva Irina V. Vinnizkaya Nataliya G. Brazovskaya Elena S. Kravchenko Tatyana E. Suslova Rostislav S. Karpov Prediction of basal glycaemia dynamics during treatment with 6-month lipid-lowering therapy in patients at high risk of cardiovascular disease
description	Background. A major meta-analysis has confirmed the ability of statins to exert both diabetogenic and hyperglycaemic effects. To date, practical recommendations for predicting glucose dynamics during lipid-lowering therapy have not been developed. Aims. Identify the combination of factors that can predict changes in basal glycaemia during 6-month lipid-lowering therapy in patients at high risk of cardiovascular disease. Methods. This study reports on 50 patients with diabetes or impaired glucose tolerance, and 18 patients with coronary artery disease without disorders of carbohydrate metabolism. Of note, 29 of the 50 diabetic or glucose intolerant patients had documented ischaemic heart disease (stable angina). Patients were randomised into three groups: Gr.1 (n=33, atorvastatin therapy), Gr.2 (n=17, atorvastatin in combination with ezetimibe) and Gr.3 (n=18, rosuvastatin therapy). After treatment for 24 weeks, we assessed lipid profile dynamics, metabolism of glucose/insulin and the HOMA-IR index. Multivariate analysis was then performed to identify factors that predicted increases in basal glycaemia. Results. All of the included patients completed 24 weeks of treatment (N=68). Lipid-lowering effect was significant in all three groups, and overall, target LDL cholesterol level was achieved in 50% of patients (n=34). In Gr.2, basal glucose level increased from 5.5(5.3–6.6) to 6.3(5.6–7.8) mmol/l (p=0.0014), which was accompanied by an increase in HOMA-IR (p=0.024). No significant change in basal glycaemia was observed in Grs.1 and 3. Moreover, an increase in the basal glycaemia was observed in 48.5% of patients in Gr.1, 70.6% in Gr.2 and 44.4% in Gr.3. Multivariate discriminant analysis across all patient groups revealed a canonical linear discriminant function that included the following factors: baseline basal glucose levels, total cholesterol levels, triglycerides and ratio of LDL/HDL cholesterol. Sensitivity and specificity of the model accounted for 75%; 51 out of the 68 cases were correctly classified when predicting the dynamics of basal glucose during lipid-lowering therapy. Conclusions. Our data demonstrate the ability to predict the dynamics of the basal glycaemia during lipid-lowering therapy. This may allow for a new way to identify patients at high risk of statin-related increases in glycaemia.
format	article
author	Olga A. Koshelskaya Anastasiya S. Sushkova Olga A. Zhuravleva Irina V. Vinnizkaya Nataliya G. Brazovskaya Elena S. Kravchenko Tatyana E. Suslova Rostislav S. Karpov
author_facet	Olga A. Koshelskaya Anastasiya S. Sushkova Olga A. Zhuravleva Irina V. Vinnizkaya Nataliya G. Brazovskaya Elena S. Kravchenko Tatyana E. Suslova Rostislav S. Karpov
author_sort	Olga A. Koshelskaya
title	Prediction of basal glycaemia dynamics during treatment with 6-month lipid-lowering therapy in patients at high risk of cardiovascular disease
title_short	Prediction of basal glycaemia dynamics during treatment with 6-month lipid-lowering therapy in patients at high risk of cardiovascular disease
title_full	Prediction of basal glycaemia dynamics during treatment with 6-month lipid-lowering therapy in patients at high risk of cardiovascular disease
title_fullStr	Prediction of basal glycaemia dynamics during treatment with 6-month lipid-lowering therapy in patients at high risk of cardiovascular disease
title_full_unstemmed	Prediction of basal glycaemia dynamics during treatment with 6-month lipid-lowering therapy in patients at high risk of cardiovascular disease
title_sort	prediction of basal glycaemia dynamics during treatment with 6-month lipid-lowering therapy in patients at high risk of cardiovascular disease
publisher	Endocrinology Research Centre
publishDate	2017
url	https://doaj.org/article/b8e14caef19448168be1bfadedef02f8
work_keys_str_mv	AT olgaakoshelskaya predictionofbasalglycaemiadynamicsduringtreatmentwith6monthlipidloweringtherapyinpatientsathighriskofcardiovasculardisease AT anastasiyassushkova predictionofbasalglycaemiadynamicsduringtreatmentwith6monthlipidloweringtherapyinpatientsathighriskofcardiovasculardisease AT olgaazhuravleva predictionofbasalglycaemiadynamicsduringtreatmentwith6monthlipidloweringtherapyinpatientsathighriskofcardiovasculardisease AT irinavvinnizkaya predictionofbasalglycaemiadynamicsduringtreatmentwith6monthlipidloweringtherapyinpatientsathighriskofcardiovasculardisease AT nataliyagbrazovskaya predictionofbasalglycaemiadynamicsduringtreatmentwith6monthlipidloweringtherapyinpatientsathighriskofcardiovasculardisease AT elenaskravchenko predictionofbasalglycaemiadynamicsduringtreatmentwith6monthlipidloweringtherapyinpatientsathighriskofcardiovasculardisease AT tatyanaesuslova predictionofbasalglycaemiadynamicsduringtreatmentwith6monthlipidloweringtherapyinpatientsathighriskofcardiovasculardisease AT rostislavskarpov predictionofbasalglycaemiadynamicsduringtreatmentwith6monthlipidloweringtherapyinpatientsathighriskofcardiovasculardisease
_version_	1718429552907124736

Prediction of basal glycaemia dynamics during treatment with 6-month lipid-lowering therapy in patients at high risk of cardiovascular disease

Ejemplares similares