Endocrinology and Metabolism

Original Article

Comparison between Atorvastatin and Rosuvastatin in Renal Function Decline among Patients with Diabetes: Eugene Han, Gyuri Kim, Ji-Yeon Lee, Yong-ho Lee, Beom Seok Kim, Byung-Wan Lee, Bong-Soo Cha, Eun Seok Kang; Endocrinol Metab. 2017;32(2):274-280. Published online June 23, 2017; DOI: https://doi.org/10.3803/EnM.2017.32.2.274

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Background

Although the beneficial effects of statin treatment in dyslipidemia and atherosclerosis have been well studied, there is limited information regarding the renal effects of statins in diabetic nephropathy. We aimed to investigate whether, and which, statins affected renal function in Asian patients with diabetes.

Methods

We enrolled 484 patients with diabetes who received statin treatment for more than 12 months. We included patients treated with moderate-intensity dose statin treatment (atorvastatin 10 to 20 mg/day or rosuvastatin 5 to 10 mg/day). The primary outcome was a change in estimated glomerular filtration rate (eGFR) during the 12-month statin treatment, and rapid renal decline was defined as a >3% reduction in eGFR in a 1-year period.

Results

In both statin treatment groups, patients showed improved serum lipid levels and significantly reduced eGFRs (from 80.3 to 78.8 mL/min/1.73 m² for atorvastatin [P=0.012], from 79.1 to 76.1 mL/min/1.73 m² for rosuvastatin [P=0.001]). A more rapid eGFR decline was observed in the rosuvastatin group than in the atorvastatin group (48.7% vs. 38.6%, P=0.029). Multiple logistic regression analyses demonstrated more rapid renal function loss in the rosuvastatin group than in the atorvastatin group after adjustment for other confounding factors (odds ratio, 1.60; 95% confidence interval, 1.06 to 2.42).

Conclusion

These results suggest that a moderate-intensity dose of atorvastatin has fewer detrimental effects on renal function than that of rosuvastatin.

Citations

Citations to this article as recorded by

Efficacy and safety of combination therapy with telmisartan, rosuvastatin, and ezetimibe in patients with dyslipidemia and hypertension: A randomized, double‐blind, multicenter, therapeutic confirmatory, phase III clinical trial
Chan Joo Lee, Woong Chol Kang, Sang Hyun Ihm, Il Suk Sohn, Jong Shin Woo, Jin Won Kim, Soon Jun Hong, Jung Hyun Choi, Jung‐Won Suh, Jae‐Bin Seo, Joon‐Hyung Doh, Jung‐Woo Son, Jae‐Hyeong Park, Ju‐Hee Lee, Young Joon Hong, Jung Ho Heo, Jinho Shin, Seok‐Min
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M V. Zykov
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Case Report

A Case of Autoimmune Hypoglycemia due to Insulin Antibody in Patient with End Stage Renal Disease.: Ji Ye Jung, Eun Seok Kang, Beom Seok Kim, Sung Wan Chun, Yumie Rhee, Chul Woo Ahn, Bong Soo Cha, Eun Jig Lee, Sung Kil Lim, Hyun Chul Lee; J Korean Endocr Soc. 2006;21(6):536-541. Published online December 1, 2006; DOI: https://doi.org/10.3803/jkes.2006.21.6.536

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17 Download

Abstract PDF: Fasting hypoglycemia results from several mechanisms. Autoimmune hypoglycemia is one of the rare causes of hypoglycemia, and characterized by hyperinsulinemia, fasting hypoglycemia and the presence of autoantibodies to insulin or insulin receptor. We report here on a 64-year-old male patient with autoimmune hypoglycemia with end stage renal disease. He had no history of diabetes or insulin use. He had experienced several severe hypoglycemic events. The serum C-peptide level was 7.48 ng/mL and the insulin concentration was 115.4 micro U/mL when the fasting plasma glucose level was 88 mg/dL. The insulin to glucose ratio was 5.42, which suggested the presence of insulinoma. Yet the radiologic studies, including magnetic resonance cholangiopancreatography, endoscopic ultrasonography and selective calcium stimulated venous sampling revealed no evidence of insulinoma. The insulin autoantibody level was 62 micro U/mL. Therefore, we could diagnosis the autoimmune hypoglycemia. The hypoglycemia was treated with prednisolone and the patient recovered from this. His insulin level decreased to 21.11 micro U/mL and the insulin autoantibody level decreased to 34 micro U/mL. Hypoglycemia in the hemodialysis patients is not uncommon. One should bear in mind autoimmune hypoglycemia as one of the causes of hypoglycemia in patients with no history of diabetes.

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