Several trials and cohort studies have shown an increased incidence of type 2 diabetes
mellitus (T2DM) in patients using statins. Whether this only applies to patients at
already high risk for the development of T2DM or for all patients is still a matter
of debate. In the present prospective cohort study of 4,645 patients with established
vascular disease without DM at baseline, 3,057 patients used statins at baseline,
of whom 1,608 used intensive statin therapy, defined as statin therapy theoretically
lowering low-density lipoprotein cholesterol with ≥40%. Cox proportional hazards models
were used to estimate the risk of incident T2DM with (intensive) statin therapy. Statin
therapy was associated with increased risk of incident T2DM (hazard ratio 1.63; 95%
confidence interval 1.15 to 2.32) when adjusted for age, gender, body mass index,
plasma high-density lipoprotein cholesterol, and plasma triglyceride levels. Intensive
statin therapy tended to be related to a higher risk of T2DM compared with moderate
statin therapy (hazard ratio 1.22; 95% confidence interval 0.92 to 1.61, adjusted
for age, gender, body mass index, plasma high-density lipoprotein cholesterol, and
plasma triglyceride levels). The increase in risk was regardless of the number of
metabolic syndrome characteristics or insulin resistance but was particularly present
in patients with low baseline glucose levels (<5.6 mmol/L; p for interaction 2.9 ×
10−7). In conclusion, statin use increases the risk of incident T2DM in patients with
clinically manifest vascular disease. The increase in risk was independent of the
number of metabolic syndrome criteria and was even more pronounced in patients with
low baseline glucose levels.
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Article Info
Publication History
Published online: November 28, 2014
Accepted:
November 25,
2014
Received in revised form:
November 25,
2014
Received:
August 29,
2014
Footnotes
See page 446 for disclosure information.
Identification
Copyright
© 2015 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
