Supplementary tables for Low-density lipoprotein cholesterol is associated with insulin secretion

Objective: Pharmacological lowering of LDL cholesterol potently reduces
cardiovascular risk while concurrently increasing type 2 diabetes risk.
The aim of this study was to investigate the relationship between LDL
cholesterol concentrations and insulin secretion and glucagon levels.
Methods: 3,039 subjects without cholesterol lowering therapy, but with
increased risk for diabetes, underwent routine blood tests and a 5-point
oral glucose tolerance test (OGTT). Glucagon concentrations, insulin
secretion and insulin clearance indices were derived from the OGTT.
    Results: There was no association
between LDL cholesterol and fasting glucagon (p=0.7, ß=-0.01) or post
glucose load glucagon levels (p=0.7, ß=-0.07), but we detected significant
positive associations of LDL cholesterol and C-peptide-based indices of
insulin secretion (AUCC-Peptide(0-30min)/AUCGlucose(0-30min): p=0.0001,
ß=0.06; AUCC-Peptide(0-120min)/AUCGlucose(0-120min): p<0.0001,
ß=-0.08). In contrast we found a negative association of insulin-based
insulin secretion indices with LDL concentrations (Insulinogenic index:
p=0.014, ß=-0.04; disposition index: p=0.0005, ß=-0.06). Though, LDL
cholesterol levels were positively associated with insulin clearance
assessed from C-peptide and insulin concentrations, both in the fasting
state and post glucose load (p<0.0001, ß=0.09 and p<0.0001,
ß=0.06, respectively). Conclusion: As C-peptide based indices reflect
insulin secretion independent of hepatic clearance, our results indicate
lower insulin secretion in case of lesser LDL cholesterol. This could
explain deteriorating glycemic control in response to cholesterol lowering
drugs.