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Meta-Analysis of Impact of Different Types and Doses of Statins on New-Onset Diabetes Mellitus

Published:January 25, 2013DOI:https://doi.org/10.1016/j.amjcard.2012.12.037
      Recent reports indicate that statins are associated with an increased risk for new-onset diabetes mellitus (DM) compared with placebo and that this relation is dose dependent. The aim of this study was to perform a comprehensive network meta-analysis of randomized controlled trials (RCTs) investigating the impact of different types and doses of statins on new-onset DM. RCTs comparing different types and doses of statins with placebo were searched for using the MEDLINE, Embase, and Cochrane databases. A search of RCTs pertinent to this meta-analysis covering the period from November 1994 to October 2012 was conducted by 2 independent investigators using the MEDLINE, Cochrane, Google Scholar, and Embase databases as well as abstracts and presentations from major cardiovascular meetings. Seventeen RCTs reporting the incidence of new-onset DM during statin treatment and including a total of 113,394 patients were identified. The RCTs compared either a statin versus placebo or high-dose versus moderate-dose statin therapy. Among different statins, pravastatin 40 mg/day was associated with the lowest risk for new-onset DM compared with placebo (odds ratio 1.07, 95% credible interval 0.86 to 1.30). Conversely, rosuvastatin 20 mg/day was numerically associated with 25% increased risk for DM compared with placebo (odds ratio 1.25, 95% credible interval 0.82 to 1.90). The impact on DM appeared to be intermediate with atorvastatin 80 mg/day compared with placebo (odds ratio 1.15, 95% credible interval 0.90 to 1.50). These findings were replicated at moderate doses. In conclusion, different types and doses of statins show different potential to increase the incidence of DM.
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      Linked Article

      • The Effect of Statin on the Incidence of Diabetes Mellitus
        American Journal of CardiologyVol. 112Issue 4
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          Navarese et al recently reported a meta-analysis of randomized controlled trials concerning the effect of various types and doses of statins on new-onset diabetes mellitus (DM). The authors concluded that pravastatin 40 mg/day was associated with the lowest risk for new-onset DM compared with placebo.1 Carter et al reported a population-based cohort study concerning the effect of various types and doses of statins on new-onset DM by setting pravastatin as a control. Although the clinical evidence was weaker than that in randomized controlled trials, these authors concluded that higher-potency statins might be contributed to the increase of new-onset DM.
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