Trial reportDiabetes2009

Muscle microvascular dysfunction in central obesity is related to muscle insulin insensitivity but is not reversed by high-dose statin treatment.

Geraldine F Clough, Magdalena Turzyniecka, Lara Walter, Andrew J Krentz, Sarah H Wild, Andrew J Chipperfield, John Gamble, Christopher D Byrne

Registry-linked trialOpen access · bronzeAbstract readRandomized Controlled Trial
In one paragraph

Trial report in Diabetes, 2009. The graph read 1 number from its abstract, feeding 1 cell of the map, but none could be read as for or against, so it casts no vote. It reports registered trial NCT00666029. Cited by 8 papers, 1 of them a synthesis that pooled it.

1number the graph read from it
0cells of the map it votes in
8citing papers in PubMed, 1 pooled it
1.9field-weighted citation impact, top 16% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

Read, but not usablea number the graph found but could not read as for or against

Cardiac & vascular functiondirection of benefit for this outcome is not defined · against placebo · dyslipidemia, hypertensionfeeds one cell of the map
decrease -51.0P < 0.001
Although 6 months' treatment with atorvastatin decreased LDL cholesterol by 51% (P < 0.001) and plasma high-sensitivity C-reactive protein by 75% (P = 0.02), microvascular function was unchanged.

clause the extractor read what became the number

2 · Its place on the map

Where it lands on the map

Rows are treatments, columns are outcomes. The coloured squares are the cells this paper feeds, coloured by the vote it casts there. Click one to jump to what this paper adds to it.

supports the treatmentfavours the comparatorno clear differenceread, but no usable result
3 · What it changes

What it adds to each cell

For every cell the paper feeds: the belief in the claim with and without this paper, and this paper's estimate drawn against every other readable study in the cell. The ringed dot is this paper.

Statins×cardiac & vascular function

No readable resultOpen on the map →What to test next →

11 readable studies in this cell: 4 favour the treatment, 6 find no difference, 1 favour the comparator.

Belief with this paper
0.50contested · 3 families support, 3 contradict · against placebo
Without itNot a counted family in this claim, so removing it changes nothing.
← favours the treatmentfavours the comparator →
0 · no effect
NCT023442907,769 enrolled · 2015
Δ -4.30-8.60 to -0.10
NCT02546323543 enrolled · 2015
Δ -0.01-0.02 to -0.00
NCT00728988499 enrolled · 2008
Δ 4.90-6.20 to 15.9
NCT0181335784 enrolled · 2013
Δ 0.00

This paper's own estimate is on a different scale from the rest of the cell, so it is not drawn here.

4 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT00666029 phase2completed

Implications for Treatment of the Metabolic Syndrome

Ran2006Enrolled40Registered outcomes2Posted comparisons0ConditionsMetabolic SyndromeArmsAtorvastatin, Placebo
PMID 19929989PMID 21166928PMID 20339006other papers from this trial
Open the trial in the graph
5 · Its place in the literature

Who cites it

8 citing papers in PubMed, 1 synthesis or guideline pooled it, 25 citations in OpenAlex.

  1. Effect of atorvastatin on testosterone levels.The Cochrane database of systematic reviews · 2021
    Pooled it
  2. Trial
  3. Article
  4. Article
  5. Article
  6. Article
  7. Vasomotion becomes less random as diabetes progresses in monkeys.Microcirculation (New York, N.Y. : 1994) · 2011
    Article
  8. Article
6 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

7 · Who and what money

Authors and funding

8 authors at 3 institutions in 1 country.

Geraldine F CloughSchool of Medicine, University of Southampton, Southampton, UK.
Magdalena Turzyniecka
Lara Walter
Andrew J Krentz
Sarah H Wild
Andrew J Chipperfield
John Gamble
Christopher D Byrne
University of Southampton · GBUniversity of Birmingham · GBUniversity of Edinburgh · GB

Funding

No grant is acknowledged in the PubMed record.

8 · The paper itself

Abstract

The marked sentences are the ones the graph read a number from.

objectiveTo test the hypotheses that decreased insulin-mediated glucose disposal in muscle is associated with a reduced muscle microvascular exchange capacity (Kf) and that 6 months of high-dose statin therapy would improve microvascular function in people with central obesity. RESEARCH DESIGN AND

methodsWe assessed skeletal muscle microvascular function, visceral fat mass, physical activity levels, fitness, and insulin sensitivity in skeletal muscle in 22 female and 17 male volunteers with central obesity whose age (mean +/- SD) was 51 +/- 9 years. We tested the effect of atorvastatin (40 mg daily) on muscle microvascular function in a randomized, double-blind, placebo-controlled trial lasting 6 months.

resultsKf was negatively associated with a measure of glycemia (A1C; r = -0.44, P = 0.006) and positively associated with insulin sensitivity (the ratio of insulin-stimulated glucose effectiveness, or M value, to the mean insulin concentration, or I value; r = 0.39, P = 0.02). In regression modeling, A1C, visceral fat mass, and M:I explained 38% of the variance in Kf (in a linear regression model with Kf as the outcome [R2 = 0.38, P = 0.005]). M:I was associated with Kf independently of visceral fat mass (B coefficient 3.13 [95% CI 0.22-6.02], P = 0.036). Although 6 months' treatment with atorvastatin decreased LDL cholesterol by 51% (P < 0.001) and plasma high-sensitivity C-reactive protein by 75% (P = 0.02), microvascular function was unchanged.

conclusionsDecreased insulin-mediated glucose uptake in skeletal muscle is associated with impaired muscle microvascular exchange capacity (Kf), independently of visceral fat mass. Muscle microvascular function is not improved by 6 months of high-dose statin treatment, despite marked statin-mediated improvements in lipid metabolism and decreased inflammation.

Indexed as

AdolescentAdultAgedAtorvastatinBiological TransportBlood PressureDouble-Blind MethodEnergy MetabolismExercise TestFemaleGlucoseHeptanoic AcidsHumansHydroxymethylglutaryl-CoA Reductase InhibitorsInsulinLipidsAtorvastatinGlucoseHeptanoic AcidsHydroxymethylglutaryl-CoA Reductase InhibitorsInsulinLipidsPyrroles

Identifiers

PMID19208914
PMCPMC2671046
OpenAlexW2170807507

What Socratic holds

Texttitle and abstract
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.