title: Lovastatin for reduction of leptin in nondialysis patients with type 2 diabetic nephropathy. The effect of simvastatin-ezetimibe combination therapy on adipose tissue hormones and systemic inflammation in patients with isolated hypercholesterolemia. Pravastatin does not affect insulin sensitivity and adipocytokines levels in healthy nondiabetic patients.
abstract: INTRODUCTION Diabetic Nephropathy ( DN ) is one of the main complications of diabetes mellitus , mostly ending to end-stage renal disease . Leptin and C-reactive protein ( CRP ) , as inflammatory markers implicated in the progression of DN , increase in diabetes mellitus , while transferrin and albumin , as members of anti-oxidant defense mechanism , are found to decline . MATERIAL S AND METHODS In a controlled clinical trial , 65 patients with type 2 DN were assigned to receive lovastatin or placebo , for 3 months , to assess statins ' impact on serum levels of leptin , CRP , transferrin , albumin , and lipid profile . RESULTS Serum levels of CRP ( 3.52 + /- 4.16 mg/dL to 2.84 + /- 3.06 mg/dL , P = .02 ) , leptin ( 10.78 + /- 8.30 mg/dL to 7.80 + /- 5.41 mg/dL , P = .006 ) , low-density lipoprotein cholesterol ( 116.16 + /- 46.54 mg/dL to 85.46 + /- 29.22 mg/dL , P = .001 ) , and total cholesterol ( 199.00 + /- 43.33 mg/dL to 164.67 + /- 35.19 mg/dL , P = .001 ) were lowered after lovastatin therapy . Mean serum level of high-density lipoprotein cholesterol increased ( 40.00 mg/dL to 42.80 mg/dL , P = .005 ) after the treatment . Lovastatin had no significant effect on albumin and transferrin . Placebo did not change any of the parameters after 3 months . CONCLUSIONS The effect of statins on the inflammatory markers involved in the development of DN is a new approach to evidence supporting the pleiotropic effect of this drug group BACKGROUND Pleiotropic effects of ezetimibe have only been investigated in a few studies . The aim of this article was to compare the effects of simvastatin and the combined treatment with simvastatin and ezetimibe on low- grade systemic inflammation and plasma levels of selected adipokines in patients with isolated hypercholesterolemia . METHODS The study included 69 patients with elevated cholesterol levels , who were allocated to one of the three groups treated for 12 weeks , respectively , with simvastatin ( 40 mg daily ) , simvastatin ( 40 mg daily ) plus ezetimibe ( 10 mg daily ) , or placebo .  Plasma levels of lipids , apolipoproteins , glucose homeostasis markers , leptin , adiponectin , visfatin , tumor necrosis factor-α ( TNF-α ) , free fatty acids ( FFA ) , and high-sensitive C-reactive protein ( hsCRP ) were determined on the allocation day and after 12 weeks of therapy . RESULTS Apart from improving lipid profile , simvastatin administered alone or in combination with ezetimibe , decreased plasma levels of hsCRP , FFA , leptin , visfatin , and TNF-α , as well as increased plasma levels of adiponectin . The combination therapy was superior to simvastatin in influencing plasma lipids/lipoproteins , hsCRP , FFA , and the investigated adipokines . The effect of the combination therapy , but not of simvastatin , on systemic inflammation and plasma adipokines was stronger in insulin-resistant than in insulin-sensitive subjects . CONCLUSIONS The obtained results suggest that insulin-resistant patients with hypercholesterolemia and high cardiovascular risk may benefit the most from the combined treatment with simvastatin and ezetimibe BACKGROUND The effect of statins on insulin resistance is controversial and poorly studied in nondiabetic subjects . In addition , the effect of statins on leptin and adiponectin has never been studied . METHODS Forty healthy nondiabetic volunteers ( 22 men and 18 women ) aged 28 to 72 were r and omized either to placebo or pravastatin 40 mg daily for a 12-week period . Insulin resistance , assessed using the Quantitative Insulin Sensitivity Check Index ( QUICKI ) , as well as serum leptin and adiponectin levels , was measured at baseline and at the end of therapy . RESULTS Pravastatin treatment decreased total cholesterol , low-density lipoprotein cholesterol , and triglycerides levels by 24 % , 32 % , and 14 % , respectively ( P < .05 for all ) , but did not affect glucose and insulin levels , the ( QUICKI ) index , and adiponectin and leptin levels . When stratification was performed according to QUICKI index or sex , no significant differences were observed in the prevalues and postvalues of leptin , adiponectin , or QUICKI index in the pravastatin group . Adiponectin , leptin , and QUICKI index were statistically higher in women than in men ( P < .001 for both variables ) . Adiponectin was negatively correlated with body mass index ( BMI ; r = -0.39 , P < .05 ) and positively correlated with the QUICKI index ( r = 0.54 , P < .001 ) and with high-density lipoprotein cholesterol ( r = 0.50 , P < .01 ) . The relation between adiponectin and QUICKI index remained significant after adjustment for sex and BMI ( P = .005 and P = .007 , respectively ) . Leptin was only related to BMI ( r = 0.57 , P < .001 ) and to sex ( P < .001 ) with no significant correlations with lipid parameters or QUICKI index . Both sex and BMI are independent predictors of leptin ( P < .001 and P < .001 ) . CONCLUSION A 12-week treatment with pravastatin 40 mg/d does not change the QUICKI index and leptin and adiponectin levels in healthy volunteers . In addition , our results emphasize the importance of sex and BMI in the determination of both adiponectin and leptin . Adiponectin was also related to QUICKI index , whereas this relation was not found with leptin
target: There was no association between the duration of statin therapy and changes in plasma leptin levels .
  Furthermore , there was no differential effect of hydrophilic and lipophilic statins on plasma leptin concentrations .
background: OBJECTIVES The effects of statins on insulin sensitivity , metabolic homeostasis and adipokines in humans are controversial .
  Several studies have investigated the impact of statin therapy on plasma leptin concentrations but the results have been inconsistent .
  The aim of the present study was to conduct a systematic review and meta- analysis of available evidence to calculate the effect size of statin therapy in changing serum leptin concentrations .