EFFECTS OF STATINS ON SUBSTRATE UTILIZATION DURING EXERCISE

Abstract

PURPOSE: Statin is the most prescribed medicine worldwide to lower cardiovascular risk. Its blood triglyceride lowering effect, may limit fat mobilization/oxidation during exercise. METHODS: Nine individuals with metabolic syndrome, chronically treated with statins to correct their dyslipidemia exercised at three increasing intensities (40, 70, and 85% VO2 MAX) while taking statins or placebo using a randomized double-blind crossover design. Indirect calorimetry and stable isotope tracer techniques were combined to assess plasma substrate kinetic and oxidation. RESULTS: As expected, statin use lowered resting plasma triglyceride concentration (i.e., PLAC 1.4±0.7 vs STAT 1.1±0.5 mmol·L-1, p = 0.003), and also plasma triglyceride concentration during exercise (i.e., PLAC 1.7±0.8 vs STAT 1.2±0.5 mmol·L-1; p < 0.001). Ra glycerol (i.e., index of whole-body lipolysis) increased along with exercise intensity but the increase was attenuated by statins (p < 0.014) at the 85% VO2 MAX exercise intensity (i.e., PLAC 7.4±1.9 vs STAT 5.8±2.2 mM·kg·min-1; p = 0.046). This 21% lower lipolysis during STAT did not limit fat oxidation that was similarly low in PLAC and STAT (i.e., PLAC 0.7±2.1 vs STAT 0.8±2.2 mM·kg·min-1; p = 0.459). STAT increased resting plasma glucose concentration (i.e., PLAC 6.6±1.6 vs STAT 6.8±1.6 mmol·L-1, p = 0.036) but did not affect exercise glucose or insulin plasma. Rates of glucose appearance (i.e., Ra glucose, index of liver glucose output) were similar during PLAC and STAT at rest and during exercise. Glucose disappearance rates increased during the first two exercise intensities (i.e., 40 and 70% VO2 MAX), but decreased in both groups at 85% VO2 explaining the ensuing hyperglycaemia at this intensity. CONCLUSIONS: Statin reduces exercise lipolysis during high intensity exercise, without affecting the already low rates of fat oxidation at that intensity. However, statin use does not affect plasma glucose kinetics or carbohydrate oxidation during exercise in a wide range of intensities in individuals chronically medicated with this drug.