BACKGROUND: Statins significantly reduce cardiovascular events in a broad 
population of patients with hyperlipidemia. However, a small, but significant 
risk of new-onset diabetes has been reported in patients treated with statins. 
The mechanism by which statins cause diabetes has not been elucidated and 
therefore preventive strategies have yet to be defined.
METHOD: Our goal was to study the differing effects of a lipophilic 
(simvastatin) statin, hydrophilic (pravastatin) statin, and ezetimibe on glucose 
transporter-4 (GLUT4) protein expression in 3T3-L1 adipocytes. We hypothesized 
that the reductions in GLUT4 protein secondary to statin treatment would be 
prevented when cells were co-incubated with coenzyme Q10 (CoQ10). GLUT4 protein 
expression was determined using the In-Cell Western technique. Confluent 
adipocytes were differentiated using a hormonal cocktail for 3 days; followed by 
treatment with simvastatin, pravastatin, ezetimibe and CoQ10. Cell morphology 
was observed after treatment using phase-contrast microscopy.
RESULTS: Treatment with simvastatin (P<0.001) and simvastatin plus ezetimibe 
(P<0.001) significantly decreased GLUT4 protein expression in the adipocytes 
compared to control conditions. GLUT4 protein levels were similar to control 
after treatment with ezetimibe alone (P=0.52) or pravastatin (P=0.32). There was 
no significant difference (P=0.098) in GLUT4 protein levels after co-treatment 
with CoQ10 between any of the treatments and control conditions.
CONCLUSION: Our studies have shown that lipophilic statins (simvastatin) reduce 
the GLUT4 protein levels in adipocytes, whereas hydrophilic statins 
(pravastatin) or ezetimibe do not. Co-treatment with CoQ10 appears to prevent 
the reduction in GLUT4 protein levels caused by simvastatin.