Naturally occurring bile acids may blunt statin-induced diabetes

Bottles of Ranbaxy Laboratories Ltd.'s atorvastatin calcium tablets lined up for photo, February 20, 2014. Photo credit: Dhiraj Singh/Bloomberg

When ursodeoxycholic acid (UDCA) is administered, Statin trends A study by a group of Chinese researchers found that it can induce glucose intolerance and diabetes.

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Statins are prescribed to people who are at high risk of: cardiovascular disease. They work by blocking the activity of enzymes involved in the metabolic pathways that produce LDL, or “bad” cholesterol. Statins are on the World Health Organization's list of essential medicines and are among the most sold medicines worldwide.

However, many studies have found statins. May increase risk Developing diabetes. “It has been known for several years that statins can cause glucose intolerance and even overt diabetes in some people,” said V. Mohan, chairman of the Madras Diabetes Research Foundation. he said on the phone. hinduism.

He added that doctors continue to prescribe statins because their benefits “far outweigh the risks.”

Nevertheless, the mechanism by which statins exert this effect is unclear.

In this study, published In the February issue of cell metabolismresearchers reported that one of the mechanisms by which statins increase glucose intolerance involves the bile acid UDCA.

The researchers recruited 30 people who were taking atorvastatin and 10 who weren't, and tracked their metabolism over a four-month period. They reported that the amount of bacteria of the genus atorvastatin was reduced in the feces of people taking atorvastatin. clostridium These people also had “altered serum and fecal bile acid profiles.”

The gut microbiome is the bacterial community in your intestines that has a symbiotic relationship with your body. The researchers clostridium-A deficient microbiome inhibited an enzyme called hydroxysteroid dehydrogenase, resulting in lower UDCA.

They also “decreased clostridiumA 12-week study in mice showed that enriched microbiota can influence bile acid synthesis and excretion, impairing glucose metabolism.

To confirm the role of UDCA, researchers recruited five participants taking statins and administered 10 to 13 mg/kg (body weight) of UDCA per day. After two months, the researchers specifically found that the individuals' HbA1C levels had “significantly decreased.”

They concluded that “UDCA restored impaired glucose homeostasis without limiting the lipid-lowering effects of statins.”

Dr Mohan called the findings “good news” and “a new angle”, but said the underlying hypothesis needed to be tested in a randomized clinical trial.

• Ursodeoxycholic acid can block the tendency of statins to induce glucose intolerance and diabetes

• Statins are on the World Health Organization's list of essential medicines and are among the most sold medicines worldwide.

• They work by blocking the activity of enzymes involved in the metabolic pathways that produce LDL, or “bad” cholesterol.

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