Abstract

Previous studies suggest that statins may disturb skeletal muscle lipid metabolism potentially causing lipotoxicity with insulin resistance. We investigated this possibility in wild-type mice (WT) and mice with skeletal muscle PGC-1α overexpression (PGC-1α OE mice). In WT mice, simvastatin had only minor effects on skeletal muscle lipid metabolism but reduced glucose uptake, indicating impaired insulin sensitivity. Muscle PGC-1α overexpression caused lipid droplet accumulation in skeletal muscle with increased expression of the fatty acid transporter CD36, fatty acid binding protein 4, perilipin 5 and CPT1b but without significant impairment of muscle glucose uptake. Simvastatin further increased the lipid droplet accumulation in PGC-1α OE mice and stimulated muscle glucose uptake. In conclusion, the impaired muscle glucose uptake in WT mice treated with simvastatin cannot be explained by lipotoxicity. PGC-1α OE mice are protected from lipotoxicity of fatty acids and triglycerides by increased the expression of FABP4, formation of lipid droplets and increased expression of CPT1b.

Highlights

  • Despite the availability of new treatment options, statins currently remain the mainstay for the treatment against hypercholesterolemia [1]

  • We have shown recently that mice with muscle PGC-1α overexpression (OE mice) treated with simvastatin were protected from impaired skeletal muscle mitochondrial dysfunction and impaired exercise capacity, suggesting a role of PGC-1α in preventing simvastatin-associated myotoxicity [30]

  • We investigated the effect of simvastatin on the plasma and skeletal lipid metabolism in wild-type mice and mice with muscle PGC-1α overexpression

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Summary

Introduction

Despite the availability of new treatment options, statins currently remain the mainstay for the treatment against hypercholesterolemia [1]. They are used mainly in the prevention and the treatment of cardiovascular diseases associated with dyslipidemia [2,3,4,5]. Statins have an excellent safety profile but are associated with skeletal muscle problems, a symptom complex called statin-associated muscle symptoms (SAMS) [7,8]. SAMS are associated with all statins on the market, with a higher prevalence for lipophilic statins such as simvastatin, possibly because of their capacity to reach extrahepatic tissues such as skeletal muscle [10,11].

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