Elevation of fasting morning glucose relative to hemoglobin A1c in normoglycemic patients treated with niacin and with statins

Rajanna, Veena; Campbell, Kevin R; Leimberger, Jeffrey D.; Mohanty, Bibhu D.; Guyton, John R.

doi:10.1016/j.jacl.2011.12.008

Cited by 15 publications

(9 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The most common adverse effect of niacin is skin flushing, which occurs in the majority of patients 115 . In addition, niacin can cause hepatotoxicity, hyperuricaemia, and hyperglycaemia 116,117 . The induction of hyperglycaemia and new onset diabetes mellitus by high doses of niacin can be harmful in patients with CKD, both with or without diabetes mellitus 118 .…”

Section: Niacinmentioning

confidence: 99%

HDL abnormalities in nephrotic syndrome and chronic kidney disease

2015

View full text Add to dashboard Cite

| Normal HDL activity confers cardiovascular and overall protection by mediating reverse cholesterol transport and through its potent anti-inflammatory, antioxidant, and antithrombotic functions. Serum lipid profile, as well as various aspects of HDL metabolism, structure, and function can be profoundly altered in patients with nephrotic range proteinuria or chronic kidney disease (CKD). These abnormalities can, in turn, contribute to the progression of cardiovascular complications and various other comorbidities, such as foam cell formation, atherosclerosis, and/or glomerulosclerosis, in affected patients. The presence and severity of proteinuria and renal insufficiency, as well as dietary and drug regimens, pre-existing genetic disorders of lipid metabolism, and renal replacement therapies (including haemodialysis, peritoneal dialysis, and renal transplantation) determine the natural history of lipid disorders in patients with kidney disease. Despite the adverse effects associated with dysregulated reverse cholesterol transport and advances in our understanding of the underlying mechanisms, safe and effective therapeutic interventions are currently lacking. This Review provides an overview of HDL metabolism under normal conditions, and discusses the features, mechanisms, and consequences of HDL abnormalities in patients with nephrotic syndrome or advanced CKD.

show abstract

Section: Niacinmentioning

confidence: 99%

HDL abnormalities in nephrotic syndrome and chronic kidney disease

2015

View full text Add to dashboard Cite

show abstract

“…A systematic review demonstrated that niacin, when used alone or in combination with statins, is associated with “modest, transient or reversible” increases in fasting glucose and elevation in hemoglobin A1c (p<0.03) 43 and a retrospective analysis (n=550) of the Duke Lipid Clinic database confirmed these findings. 44 …”

Section: Resultsmentioning

confidence: 99%

The Impact of Cardiovascular Drugs on Glycemic Control: A Review

et al. 2017

View full text Add to dashboard Cite

Introduction The prevalence of diabetes is steadily rising in the US, both in the general population and among those with cardiovascular disease (CVD). Understanding how to treat a patient with both conditions is becoming increasingly important. With multiple therapeutic options for CVD management, some medications will invariably impact glycemia in this group of patients. The concept of “DM-friendly” management of CVD is based on a treatment approach of selecting medications that do not impair glycemic control, provided equivalent cardioprotective effects. This article reviews the glycemic effects of various classes of medications commonly used to treat CVD. Methods Data sources were all PubMed and Google Scholar-referenced articles in English-language peer-reviewed journals from 1980 to the present. Studies selected could include observational studies or prospective clinical trials. Prospective clinical trials included in this review focused on investigating the association of the medication of interest with glycemic outcomes. Meta-analyses and systematic reviews were also included. Results The data on glycemic effects was lacking for many of the medication classes and individual medications examined. However, in our review, certain beta-blockers and renin angiotensin aldosterone system inhibitor (RAAS-i) agents, and select CCBs were consistently shown to have favorable glycometabolic profiles when compared with other commonly used cardiovascular therapies. Conclusions Several commonly prescribed medications for the treatment of cardiovascular disease, such as certain beta-blockers, RAAS agents, and ranolazine, are associated with favorable glycometabolic effects. As clinicians are more often faced with the challenge of treating patients with diabetes and concomitant cardiovascular disease, consideration of how common cardiovascular medications may affect glycemia should be incorporated into the clinical decision making process.

show abstract

“…Crystalline NiAc dosing seems to raise net plasma FFA levels, due to marked rebound between doses, and induces insulin resistance ( 25,38 ). ER formulations might do better, but reported effects on glucose control are generally either neutral or negative ( 16,17,42,45 ). This could result from a failure of the ER formulations to lower FFA, either on average or at the time point of glucose control assessment.…”

Section: Discussionmentioning

confidence: 99%

Dosing profile profoundly influences nicotinic acid's ability to improve metabolic control in rats

Kroon

Kjellstedt

Thalén

et al. 2015

Journal of Lipid Research

View full text Add to dashboard Cite

explored and provide evidence supporting this concept. This includes inactivation of hormone sensitive lipase (HSL) ( 5, 6 ) and A 1 -adenosine receptor agonists ( 7 ). In addition, several other G protein-coupled receptors (GPRs) are involved in controlling adipocyte FFA release, including GPR43, GPR81, and GPR109A ( 8-10 ).The GPR109A agonist nicotinic acid (NiAc) has been used clinically ever since its antidyslipidemic effects (HDL elevation and reductions of total cholesterol, LDL-cholesterol, and TG) were discovered more than 50 years ago ( 11-15 ). Although NiAc potently lowers FFA acutely, large-scale clinical studies, with repeated oral NiAc administration, often report increased levels of fasting glycemia ( 16-19 ). NiAc has not been optimized to achieve durable and therapeutically meaningful FFA lowering. By this, we specifi cally mean reducing around-the-clock FFA area under the curve (AUC). In theory, this might be achieved by sustained NiAc exposure; however, the FFA-lowering effect seen initially appears to be lost over time despite maintained NiAc exposure (tolerance development) ( 20 ). Time-dependent loss of both FFA lowering and glucose control improvement also occur in patients with type 2 diabetes, treated with the NiAc analog acipimox ( 21,22 ). To avoid tolerance development, drug holidays are needed. However, at the end of each NiAc exposure period, there is the risk of FFA rebound (here referring to the situation where FFA overshoots pretreatment levels in connection with NiAc decline) due to the short NiAc plasma half-life ( 23 ). FFA rebound is associated with impaired glucose control ( 24, 25 ). The question of whether there might be an optimal balance between periods of continuous exposure (which would minimize rebound) and drug holidays (which would minimize tolerance) in order to achieve maximal FFA lowering has not been addressed. Lipid overload in nonadipose tissues has been linked to the pathogenesis of insulin resistance and atherogenesis ( 1-4 ). A potential means for reversing peripheral lipid overload is to restrict the release of FFAs from adipose tissues. A number of independent mechanisms have been N.D. Oakes, P. Thalén, and A. Kjellstedt Abbreviations: ATGL, adipocyte triglyceride lipase; AUC, area under the curve; ER, extended release; GIR, glucose infusion rate; GPR, G protein-coupled receptor; HOMA-IR, homeostasis model assessment for insulin resistance; HSL, hormone sensitive lipase; NiAc, nicotinic acid; PDE-3B, phosphodiesterase-3B .

show abstract

Elevation of fasting morning glucose relative to hemoglobin A1c in normoglycemic patients treated with niacin and with statins

Cited by 15 publications

References 27 publications

HDL abnormalities in nephrotic syndrome and chronic kidney disease

HDL abnormalities in nephrotic syndrome and chronic kidney disease

The Impact of Cardiovascular Drugs on Glycemic Control: A Review

Dosing profile profoundly influences nicotinic acid's ability to improve metabolic control in rats

Contact Info

Product

Resources

About