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Low concentration of plasma cholesterol and type 2. diabetes mellitus

Czech version

Authors: Jaroslav A. Hubáček 1,2
Authors‘ workplace: Centrum experimentální medicíny, IKEM, Praha 1;  III. interní klinika – klinika endokrinologie a metabolismu 1. LF UK a VFN v Praze 2
Published in: AtheroRev 2021; 6(1): 40-43
Category:

Overview

Statins are the most commonly prescribed drugs, effective and with a low incidence of undesirable side effects. Among the undesirable side effects of statin therapy, the increased risk of type 2 diabetes (T2DM) is discussed. A quarter of century ago, a lower incidence of diabetes was observed in patients with familial hypercholesterolemia. Increased risk of T2DM in statin users has also been observed in some clinical trials. A Mendelian randomization study showed that the increased risk of developing T2DM has causality in the inhibition of HMGCoA reductase activity – activity, whose is blocked by statins. Other genes whose variants have been used as “proxies” to analyze the causality between lowering cholesterol and increasing the risk of T2DM are NPC1L1 (an inhibitor of intestinal cholesterol absorption) and PCSK9 (a protein that controls LDL-receptor degradation). Also here has been confirmed, that genetic variants associated with lower cholesterol levels are also associated with increased risk of T2DM. The risk assessment of the development of complex “civilization” noncommunicable diseases should be strictly individualized and comprehensive, with careful consideration of all potential undesirable side effects of (not only) dyslipidemic treatment for each individual.

Keywords:

diabetes – ezetimibe – familial hypercholesterolemia – Genetics – mendelian randomisation – PCSK9 inhibitor – statin

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Labels
Angiology Diabetology Internal medicine Cardiology General practitioner for adults
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