AHA: At Every Dose Simvastatin (Zocor) Reduces Metabolic Markers

ORLANDO, Nov. 9 -- Simvastatin (Zocor) reduced adiponectin levels and insulin sensitivity in hypercholesterolemic patients, even among patients taking as much as 80 mg a day of the statin, researchers here reported.
Action Points
Explain to interested patients that this study suggests that, in addition to its beneficial effect on cholesterol, simvastatin (Zocor) may improve other markers for cardiometabolic disease -- such as insulin resistance and serum adiponectin.
Note that this study was published as an abstract and presented at a conference. The data and conclusions should be considered to be preliminary until published in a peer-reviewed publication.
Previous studies have reported unfavorable pleiotropic effects, including an increase in insulin resistance, associated with high doses of lipophilic statins such as simvastatin.
In this study, 80-mg doses of simvastatin significantly decreased plasma adiponectin levels by 19%, and insulin sensitivity was reduced by 6% (P0.05 by paired t-test), according to Michael J. Quon, M.D., Ph.D., chief of the diabetes unit at the National Center for Complementary and Alternative Medicine at NIH in Bethesda, Md.
At 10-, 20-, 40-, and 80-mg doses, simvastatin significantly decreased plasma adiponectin levels by 4%, 12%, 5%, and 10%, respectively, and insulin sensitivity was reduced by 5%, 8%, 6%, and 6%, Dr. Quon and colleagues reported at the American Heart Association meeting.
Those changes were also significant compared to placebo (P=0.011 for adiponectin and P=0.034 for insulin sensitivity), but the magnitude of the changes was not significantly different among four different doses of simvastatin therapies, he said.
The investigators tested the four different doses of simvastatin in a randomized, double-blind, placebo-controlled parallel study of 156 patients with hypercholesterolemia.
All patients were put on low-fat diets and randomized into five groups: placebo, 10 mg, 20 mg, 40 mg, and 80 mg for a two-month treatment period. The groups were well balanced for age, sex, and BMI.
Total cholesterol, LDL, plasma adiponectin, and insulin sensitivity were measured at baseline and following treatment.
Among the findings:
Compared with baseline, simvastatin reduced total cholesterol by 27% (10 mg), 25% (20 mg), 37% (40 mg), and 38% (80 mg), and reduced LDL by 39%, 38%, 52%, and 58%, respectively (P0.001).
Simvastatin reduced apolipoprotein B levels by 24% (10 mg), 30% (20 mg), 36% (40 mg), and 42% (80 mg), which was also significant (P0.001).
Placebo was associated with a significant reduction (P0.05) reduction in total cholesterol and LDL cholesterol, but did not significantly reduce plasma adiponectin levels or insulin sensitivity.
The study was supported by the National Center for Complementary and Alternative Medicine. The authors reported no financial conflicts.
Primary source: American Heart AssociationSource reference: Koh K, Quon M, "Simvastatin reduces adiponectin levels and insulin sensitivity in hypercholesterolemic patients regardless of doses" AHA Meeting 2007; Abstract 3516.