High-dose atorvastatin is associated with lower IGF-1 levels in patients with type 1 diabetes

• The IGF-1/IGFBP-1 hormonal axis plays an important role in microvascular health.
• Type 1 diabetics frequently medicate with HMG-CoA reductase inhibitors, statins.
• We studied the effect of atorvastatin on IGF-1/IGFBP-1 in twenty type 1 diabetics.
• Atorvastatin treatment was associated with significantly lower levels of IGF-1.
• This could have negative effects on microvascular health in these patients.

IntroductionInsulin-like growth factor 1 (IGF-1) and insulin-like growth factor binding protein 1 (IGFBP-1) play an important role in vascular health. Many patients with type 1 diabetes are medicated with HMG-CoA reductase inhibitors, statins, in order to prevent vascular complications. Yet little is known about the effect of statins on the IGF-1/IGFBP-1 axis in these patients.ObjectivesThe aim of this study was to evaluate the effect of atorvastatin treatment on IGF-1 and IGFBP-1 with regards to microvascular function.DesignTwenty patients with type 1 diabetes received either placebo or 80 mg atorvastatin for two months in a double-blinded cross-over study. IGF-1 and IGFBP-1 levels were assessed before and after each treatment period. Skin microcirculation was studied using Doppler perfusion imaging during iontophoresis of acetylcholine and sodium nitroprusside to assess endothelium-dependent and endothelium-independent microvascular reactivity, respectively.ResultsTreatment with high-dose atorvastatin was associated with a significant decrease in IGF-1 levels compared to placebo (p < 0.05, ANOVA repeated measures), whereas no effect was seen on IGFBP-1 or the IGF-1/IGFBP-1 ratio. These variables did not correlate with measurements of skin microvascular reactivity.ConclusionsThe study found that treatment with high-dose atorvastatin was associated with reduced IGF-1 levels, which may indicate a potential negative effect on microvascular function and long-term risk of microangiopathy development.