Pravastatin improved glucose metabolism associated with increasing plasma adiponectin in patients with impaired glucose tolerance and coronary artery disease

Abstract

Reduced incidence of type-2 diabetes has been shown in patients treated with pravastatin. Adiponectin can exhibit beneficial effects on glucose metabolism. We investigated whether pravastatin could improve glucose tolerance associated with increasing adiponectin levels in patients with impaired glucose tolerance (IGT). This study consisted of 40 coronary artery disease (CAD) patients with IGT assessed by oral glucose tolerance test (OGTT). Patients were randomized to receive pravastatin ( n = 20) or no lipid-lowering medications (control group, n = 20) for 6 months, after which OGTT was repeated and adiponectin levels were measured. Pravastatin treatment significantly decreased levels of total cholesterol (16%), low-density lipoprotein cholesterol (23%) and high-sensitivity C-reactive protein (37%) ( p < 0.01, respectively). At 2 h in OGTT, pravastatin significantly improved hyperglycemia (−14%) and hyperinsulinemia (−23%). Pravastatin treatment significantly elevated plasma adiponectin levels (35%; p < 0.001) but not in the control group. The glucose reduction at 2 h post-OGTT was significantly associated with increased levels of adiponectin ( r = −0.462; p = 0.003). Pravastatin treatment is an independent predictor for improvement of post-loaded hyperglycemia (odds ratio; 5.7; 95% confidence interval 1.7–19.3; p = 0.003) and achieved beneficial conversion from IGT to normal glucose tolerance (40%; p = 0.03). Pravastatin exhibits beneficial effects on glucose metabolism especially in the postprandial state associated with increasing plasma adiponectin levels in CAD patients with IGT.