Diabetic cardiac autonomic neuropathy: Effects of statins and omega-3 polyunsaturated fatty acids on lipid profile and insulin resistance parameters

Serhiyenko, Victoria; Serhiyenko, Ludmila; Ajmi, Samir; Serhiyenko, Alexandr

doi:10.15761/crt.1000274

Cited by 4 publications

(3 citation statements)

References 31 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In summary, statins [18]: decrease LDL-C ~ 21-55% by competitively inhibiting rate-limiting step of cholesterol synthesis in the liver, leading to upregulation of hepatic LDL receptors (primarily); decrease TG ~ 6-30% and increase HDL-C ~ 2-10%. Thus, hyperinsulinemia/IR, lipid metabolism disorders are accompanied by an increase the concentration of TG, TC and LDL-C, decrease HDL-C in patients with T2DM, in particular, with CAN [6,19]. Therefore, the appointment of statins is necessary in the treatment of DLP in patients with T2DM with definite stage of cardiovascular autonomic neuropathy.…”

Section: Discussionmentioning

confidence: 99%

Diabetic Cardiac Autonomic Neuropathy: Simvastatin, Insulin Resistance and Lipids

et al. 2022

Self Cite

View full text Add to dashboard Cite

Treatment of diabetic cardiac autonomic neuropathy (CAN) is a complex process, that includes: lifestyle modification; reducing of insulin resistance (IR); optimal glycemic control; management of diabetic dyslipidemia; antioxidants; vitamins; of myocardial metabolic abnormalities; thrombosis and others. The aim of study was to investigate the effects of simvastatin on insulin resistance and blood lipid profile parameters in patients with type 2 diabetes mellitus (T2DM) and the definite stage of cardiac autonomic neuropathy. The study involved 107 patients with T2DM among them 16 patients without CAN, 19 with subclinical stage of CAN and 72 with definite CAN. Median age of patients was 53.6 ± 0.41 yrs, disease duration - 4.12 ± 0.24 yrs and median glycated hemoglobin (HbA1c) - 7.01% ± 0.09%. The control group included 14 almost healthy people without DM. Patients with definite CAN were allocated into two treatment groups: 1st group - 22 patients received standard hypoglycemic therapy and simvastatin 20 mg/day; 2nd group - control (n = 15). The duration of the study was 3 mos. The concentrations of glucose, HbA1c, immunoreactive insulin (IRI) in the blood were determined. Lipid metabolism was assessed by the concentration of total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), triglycerides (TG) measurements. The IR index (HOMA-IR), atherogenic coefficient (AC), TG/HDL-C parameters, and TG-glucose (TyG) index were calculated. It was established that in patients with T2DM with subclinical stage of CAN there was statistically significant increase in the parameters of HbA1c, IRI, TC, TG and HOMA-IR, AC, TyG indices and decrease of TG/HDL-C and HDL-C compared to control; increase of IRI, TG, TG/HDL-C and TyG indices compared to patients with T2DM without CAN. The definite stage of CAN is characterized by an increase of HbA1c, IRI, TC, LDL-C levels and HOMA-IR, AC indices and a significant decrease in the concentration of HDL-C (compared to patients with subclinical CAN). As a result of our study, we found out that prescription of simvastatin to patients with definite stage of CAN was accompanied by a statistically significant decrease in the concentration of TC, LDL-C, TG and an increase in the content of HDL-C (compared to 2nd, control group). Obtained results justify the appropriateness of statins prescription to patients with T2DM and the definite stage of CAN.

show abstract

Section: Discussionmentioning

confidence: 99%

Diabetic Cardiac Autonomic Neuropathy: Simvastatin, Insulin Resistance and Lipids

et al. 2022

Self Cite

View full text Add to dashboard Cite

show abstract

“…Thus, hyperinsulinemia/IR, lipid metabolism disorders are accompanied by an increase the concentration of TG, TC and LDL-C, decrease HDL-C in patients with type 2 DM, in particular, with CAN [6,19]. Therefore, the appointment of statins is necessary in the treatment of DLP in patients with type 2 DM with definite stage of cardiovascular autonomic neuropathy.…”

Section: Discussionmentioning

confidence: 99%

Diabetic Cardiovascular Autonomic Neuropathy: Insulin Resistance, Lipids and Simvastatin

Serhiyenko¹,

Ajmi²,

Serhiyenko³

2020

JICOA

Self Cite

View full text Add to dashboard Cite

Background: Treatment of diabetic cardiac autonomic neuropathy (CAN) is a complex process, that includes: lifestyle modification; reducing of insulin resistance (IR); optimal glycemic control; management of diabetic dyslipidemia; antioxidants; vitamins; treatment of myocardial metabolic abnormalities; thrombosis and others. The aim of study was to investigate the effects of simvastatin on insulin resistance and blood lipid profile parameters in patients with type 2 diabetes mellitus (DM) and the definite stage of cardiac autonomic neuropathy. Methods: The study involved 107 patients with type 2 DM among them 16 patients without CAN, 19 with subclinical stage of CAN and 72 with definite CAN. Median age of patients was 53.6±0.41 years, disease duration - 4.12±0.24 years and median glycated hemoglobin (HbA1c) - 7.01%±0.09%. The control group included 14 almost healthy people without DM. Patients with definite CAN were allocated into two treatment groups: 1st group - 22 patients received standard hypoglycemic therapy and simvastatin 20 mg/day; 2nd group - control (n = 15). The duration of the study was 3 mos. The concentrations of glucose, HbA1c, immunoreactive insulin (IRI) in the blood were determined. Lipid metabolism was assessed by the concentration of total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), triglycerides (TG) measurements. The IR index (HOMA-IR), atherogenic coefficient (AC), TG/HDL-C parameters, and TG-glucose (TyG) index were calculated. Result: It was established that in patients with type 2 DM with subclinical stage of CAN there was statistically significant increase in the parameters of HbA1c, IRI, TC, TG and HOMA-IR, AC, TyG indices and decrease of TG/HDL-C and HDL-C compared to control; increase of IRI, TG, TG/HDL-C and TyG indices compared to patients with type 2 DM without CAN. The definite stage of CAN is characterized by an increase of HbA1c, IRI, TC, LDL-C levels and HOMA-IR, AC indices and a significant decrease in the concentration of HDL-C (compared to patients with subclinical CAN). As a result of our study, we found out that prescription of simvastatin to patients with definite stage of CAN was accompanied by a statistically significant decrease in the concentration of TC, LDL-C, TG and an increase in the content of HDL-C (compared to 2nd, control group). Conclusion: Obtained results justify the appropriateness of statins prescription to patients with type 2 DM and the definite stage of CAN.

show abstract

“…Львівський національний медичний університет імені Данила Галицького Механізми, за допомогою яких статини можуть призвести до розвитку ЦД 2 типу, не повністю з'ясовані, але в ці процеси можуть бути залучені як цільові, так і позацільові ефекти, зокрема вплив на мевалонатний шлях, що супроводжується пригніченням декількох шляхів клітинного біосинтезу [9][10][11]. Тривале лікування статинами активує процеси глюконеогенезу, посилюючи експресію генів ключових ферментів, які збільшують продукцію глюкози в печінці.…”

Section: в о сергієнко о о сергієнкоunclassified

Diabetogenic action of statins — mechanisms and consequences. Review

Serhiyenko¹,

Serhiyenko²

2022

CE&ES

View full text Add to dashboard Cite

Over the past 20 years, the data according to the primary and secondary prevention of cardiovascular disease (CVD) in patients with type 2 diabetes mellitus (DM 2), usually using predefined subgroup analyses, has consistently shown conclusive evidence of reduced relative and absolute risk of CVD. However, enthusiasm for using 3-hydroxyl-3-methylglutaryl-coenzyme A (HMG-CoA) reductase inhibitors has been significantly reduced by the results of follow up of patients in whom DM developed against the background of statins’ administration.The mechanisms by which statins may contribute to the DM 2 development have not been fully understood, but both targeted and non-targeted effects may be involved. These effects include: the effects on the mevalonate pathway, accompanied by inhibition of several pathways of cellular biosynthesis; activation of gluconeogenesis processes by increasing the expression of key enzyme genes; disruption of insulin signalling pathways; changes in circulating free fatty acids; hormones; functional and structural state of β-cells; maturation/differentiation of adipocytes. Additional mechanisms, particularly epigenetic regulation mediated by specific miRNAs (a class of short non-coding RNA molecules involved in the regulation of RNA translation and degradation), are also involved in the reduction of insulin secretion.Currently investigations are being conducted to elucidate the statin-induced mechanisms of DM 2 development. It has been established that therapy with HMG-CoA reductase inhibitors, although it affects the accession of DM 2, but helps to reduce the accession and/or progression of CVD. Therefore, statins should be continued in patients at high or very high risk of CVD to achieve the target levels of low-density lipoprotein cholesterol. Therefore, before starting treatment, it is necessary to assess the degree of risk. HbA1c and blood glucose levels should be monitored regularly in people at high risk for developing DM 2 who receive statins.

show abstract

Diabetic cardiac autonomic neuropathy: Effects of statins and omega-3 polyunsaturated fatty acids on lipid profile and insulin resistance parameters

Cited by 4 publications

References 31 publications

Diabetic Cardiac Autonomic Neuropathy: Simvastatin, Insulin Resistance and Lipids

Diabetic Cardiac Autonomic Neuropathy: Simvastatin, Insulin Resistance and Lipids

Diabetic Cardiovascular Autonomic Neuropathy: Insulin Resistance, Lipids and Simvastatin

Diabetogenic action of statins — mechanisms and consequences. Review

Contact Info

Product

Resources

About