Effect of UDCA on the New Onset Diabetes and Glucose Intolerance Induced by Statin-A Multicenter, Prospective, Random Controlled Trial

  • STATUS
    Recruiting
  • End date
    Dec 31, 2024
  • participants needed
    1000
  • sponsor
    First Affiliated Hospital Xi'an Jiaotong University
Updated on 16 October 2022
cardiovascular disease
insulin
fasting
type 2 diabetes mellitus
fasting blood glucose
hemoglobin a1c
glycosylated hemoglobin
c-peptide
hmg-coa reductase inhibitors

Summary

At present, it is recognized that statins are the cornerstone of treatment for the prevention of major cardiovascular events in patients with atherosclerotic cardiovascular disease (ASCVD); However, at the same time, the increased risk of long-term glucose tolerance and type 2 diabetes mellitus caused by statin therapy has attracted wide attention. The investigators' recent study found that the levels of glycosylated hemoglobin, insulin and C-peptide increased significantly with the extension of follow-up time in patients with hyperlipidemia. At the same time, serum and fecal bile acid metabolism profiles, especially secondary bile acid metabolism, were extensively changed, especially in ursodeoxycholic acid (UDCA), suggesting that the decrease of UDCA is a possible mechanism for statins to induce side effects of diabetes. According to this hypothesis, ursodeoxycholic acid combined with statins may improve the abnormal glucose tolerance caused by statins and maximize the benefit of statins. This study is a multicenter, prospective, randomized, parallel, double-blind placebo-controlled, cohort study. Taking ASCVD patients as the research object, the investigators will compare the changes of glycosylated hemoglobin, fasting blood glucose, fasting insulin, C-peptide and metabolomic indexes before and after the use of ursodeoxycholic acid combined with atorvastatin and atorvastatin alone and during follow-up, Further evaluate the changes of blood glucose related indexes before and after the use of ursodeoxycholic acid combined with atorvastatin and atorvastatin alone, clarify the possible mechanism and specific treatment targets of abnormal glucose tolerance caused by statin, and put forward a possible alternative treatment for the disorder of glucose metabolism caused by statin.

Details
Condition Diabetes Mellitus
Treatment UDCA
Clinical Study IdentifierNCT05500937
SponsorFirst Affiliated Hospital Xi'an Jiaotong University
Last Modified on16 October 2022

Eligibility

Yes No Not Sure

Inclusion Criteria

Age ≥ 18 years old and < 80 years old, regardless of gender
For those who had indications for taking statins for more than half a year, glycosylated hemoglobin increased by more than 0.5 and > 6.1% compared with half a year ago
Agree to accept the study treatment plan and voluntarily sign the informed consent form

Exclusion Criteria

previous diagnosis of diabetes mellitus
Received hypoglycemic drug treatment
The level of abdominal blood glucose at baseline was ≥ 7mmol / L
Need to take glucocorticoids for a long time
Acute myocardial infarction and stroke occurred in the last 6 months
Severe liver dysfunction
Glomerular filtration rate (EGFR) < 30ml / min / 1.73m2 (MDRD formula)
Malignant tumor
Blood system diseases
Acute or severe systemic infection
Women during pregnancy, lactation and preparation for pregnancy
Alcohol and other drug addicts and mental patients
Patients who are participating in other clinical studies or withdraw from less than 1 month
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