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Rosuvastatin Improves Hip Bone Mineral Density but Worsens Insulin Resistance
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Reported by Jules Levin
CROI 2014 March 3-6 Boston, MA
Grace A McComsey, Ying Jiang, Kristine M. Erlandson, Sara M. Debanne, on behalf of the SATURN-HIV team
from NATAP Report by Mark Mascolini:
"Statins boost expression of the bone morphogenetic protein 2, which enhances bone formation, noted principal investigator Grace McComsey (Case Western University Cleveland), and recent studies found modest BMD gains with statins. But the impact of statins on BMD had not been studied in HIV-positive people until this trial. Studies in people with HIV--and in the general population--have yielded conflicting results on whether and how statins affect glucose, insulin, and diabetes risk......Rosuvastatin for 48 weeks significantly increased fasting glucose 8% (P = 0.0017 versus baseline, P = 0.217 versus 3.3% rise with placebo), fasting insulin 52% (P = 0.0006 versus baseline, P = 0.0055 versus 5.5% rise with placebo), and insulin resistance as measured by HOMA-IR 72% (P = 0.0015 versus baseline, P = 0.0068 versus 14.5% rise with placebo). Diabetes developed in only 1 study participant, who was taking placebo..... A study like this cannot discern whether the changes seen are particular to rosuvastatin or apply to other statins as well. McComsey noted that larger and longer studies are needed to see whether statins prevent fractures. Follow-up will continue through 96 weeks. These 48-week findings indicate a need for close glucose and insulin monitoring in HIV-positive people taking statins."
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