Niacin To Lower Cholesterol
September 24, 2000
Niacin May Lower Cholesterol Without
Affecting Glucose Levels
The B vitamin niacin (nicotinic acid) is well-known
to positively affect cholesterol levels, particularly by increasing
levels of HDL cholesterol, but is not currently recommended for
diabetic patients due to concerns that it might adversely impact
upon control of blood glucose levels.
However, the authors of a new study note that
this recommendation is not based upon adequate evidence, so they
decided to investigate further both the safety and efficacy of niacin
in diabetic patients.
A prospective, randomized, placebo-controlled
clinical trial was conducted in 6 clinical centers from August 1993
to December 1995.
A total of 468 participants were studied,
including 125 with diabetes, who had diagnosed peripheral arterial
Participants were randomly assigned to receive
niacin - 3000 mg/d or maximum tolerated dosage or placebo for up
to 60 weeks.
Researchers measured cholesterol, glucose,
hemoglobin A1c (HbA1c), alanine aminotransferase, and uric acid
levels, in addition to monitoring hypoglycemic drug use; compliance;
and adverse events.
Niacin use had similar effects on lipid parameters
in patients with and without diabetes such as:
Increased HDL cholesterol by 29% in both
Decreased triglycerides by 23% and 28%
Decreased LDL cholesterol by 8% and 9%
However, glucose levels were modestly increased
by niacin by 8.7 and 6.3 mg/dL in participants with and without
Levels of HbA1c were unchanged by niacin use
in participants with diabetes.
The authors state that "Our study suggests
that lipid-modifying dosages of niacin can be safely used in patients
with diabetes and that niacin therapy may be considered as an alternative
to statin drugs or fibrates for patients with diabetes in whom these
agents are not tolerated or fail to sufficiently correct hypertriglyceridemia
or low HDL-C levels."