Volume 5 Issue 8 - 2018
Decline in Low-Density Lipoprotein Cholesterol by Pharmacotherapy and the Risk of New-Onset Diabetes
Jan Fedacko1, Mami Noda2, Ram B Singh3*, Viliam Mojto4, Jarmila Kucharaska5, Anna Gvozdjakova5, Mohammed Bassim I6, Hadi Najah R7, Jabber Huda7 and Galal Elkilany8
1PJ Safaric University, Kosice, Slovakia
2Graduate School of Pharmaceutical Sciences, Fukuoka, Japan
3Halberg Hospital and Research Institute, Moradabad, India
4Third Department of Internal Medicine, Comenius University, Bratislava
5Pharmacobiochemical Laboratory of the 3rd Department of Internal Medicine, Comenius University, Bratislava, Slovakia
6University of Al Qadisiyah, Qadisiyah, Iraq
7Kufa University, Najaf, Iraq
8Gulf Medical College, Ajnam, UAE
*Corresponding Author: Ram B Singh, Halberg Hospital and Research Institute, Moradabad, India.
Received: June 25, 2018; Published: July 05, 2018
Citation: Ram B Singh., et al. “Decline in Low-Density Lipoprotein Cholesterol by Pharmacotherapy and the Risk of New-Onset Diabetes”. EC Cardiology 5.8 (2018): 486-495.
There is evidence that lipid lowering therapy due to statins, niacin and PCSK9 inhibiters on long term use can predispose new onset incident diabetes. A recent meta-analysis demonstrated that statin therapy was associated with a risk of diabetes which needs further attention. The study revealed that relative reduction in low-density lipoprotein cholesterol (LDL-C) was a good indicator of the risk of new-onset diabetes. This meta-analysis included 14 clinical trials of which 8 trials with target LDL-C levels ≤ 100 mg/ dL (2.6 mmol/L) or LDL-C reductions of at least 30% were extracted separately. The overall risk of incident diabetes increased by 11% and the group with intensive LDL-C reduction statin had an 18% increase in the likelihood of developing diabetes. The risks of incident diabetes were 13% and 29% in the subgroups with 30 - 40% and 40 - 50% reductions in LDL-C, respectively. These findings showed that LDL-C decrease may provide a dynamic risk assessment parameter for new-onset diabetes. It is possible that LDL-C lowering may be positively related to the risk of new-onset diabetes. It is important that blood glucose monitoring should be done, if there is 30% decline in LDL cholesterol during lipid lowering therapy, to detect incident diabetes in these populations. However, all statins do not have same effects; rosuvastatin and atorvastatin administration is more commonly and pita vastatin least commonly associated with diabetes. The new antibody PCSK9 inhibiter can also cause impaired glucose intolerance on long term administration without any weight gain which is common with statin therapy. Interestingly, dietary measures and physical activity used for lowering cholesterol also decreases diabetes which poses the possibility that these methods are not used properly when drugs are administered for reducing blood cholesterol as it may be due to decreased insulin sensitivity.
Keywords: LDL Cholesterol; Beta Cell Dysfunction; PCSK9 Inhibiters; Incident Diabetes
Copyright: © 2018 Ram B Singh., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

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