Effect of Serum LDL Cholesterol Concentration on Pancreatic Insulin Secretion

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    University Hospital Tuebingen
Updated on 21 July 2021
cardiovascular disease
type 2 diabetes mellitus
insulin resistance
low density lipoprotein
LDL Cholesterol
serum cholesterol
cholesterol measurement
hmg-coa reductase inhibitors
serum low density lipoprotein


Dyslipidemia is characterized by low levels of HDLs, hypertriglyceridemia as well as an increases proportion of small dense LDLs. Changes in lipoprotein particles and its concentrations, especially increased levels of pro-atherogenic LDL particles play an important role in the development of cardiovascular diseases. It is well established that statin/PCSK9-inhibitor treatment is very effective in lowering LDL cholesterol levels and therefore in preventing cardiovascular events. Besides the beneficial effects on cardiovascular system, these therapies are unfortunately linked to increased risk for type 2 diabetes.

However underlying mechanisms for the association between LDL cholesterol levels and the risk for type 2 diabetes remains largely unknown.Type 2 diabetes is especially characterized by insulin resistance and impaired insulin secretion from pancreatic beta-cells. Insulin resistance alone is insufficient to cause type 2 diabetes, as long as the -cell is able to compensate for the increased demand for insulin. Once this compensatory mechanism reaches its physiological limits, individuals progress to type 2 diabetes. Accordingly we aimed to investigate the associations between LDL cholesterol concentrations and the key issue in the pathogenesis of type 2 diabetes, insulin secretion before and after lowering cholesterol concentration by treatment with Evolocumab for 12 weeks in patients with medical indication for a treatment with a PCSK9-inhibitor. Therefore, patients will either undergo a hyperglycemic clamp or a oral glucose tolerance test in randomized manner.

Condition Hypercholesterolemia, elevated cholesterol, Insulin Secretion, High Cholesterol, Hyperlipidemia, Insulin Resistance, hypercholesteremia, High Cholesterol (Hyperlipidemia)
Treatment Lowering cholesterol concentrations by PCSK-9 inhibitor
Clinical Study IdentifierNCT04314167
SponsorUniversity Hospital Tuebingen
Last Modified on21 July 2021


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Inclusion Criteria

Understand and voluntarily sign an informed consent document prior to any study related assessments/procedures
Medical indication for the treatment with a PCSK9-inhibitor
HbA1c < 6,5%

Exclusion Criteria

Diabetes mellitus
Pregnant women or breastfeeding
Hb < 11.5 g/dl (males) or Hb < 10.5 g/dl (females)
treatment with any medication that effects on blood glucose concentrations, e.g. antidiabetic drugs or steroids
Any pancreatic disease
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