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Effect of statin therapy on incident type 2 diabetes mellitus in patients with clinically manifest vascular disease.
Am J Cardiol 2015; 115(4):441-6AJ

Abstract

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.

Authors+Show Affiliations

Department of Vascular Medicine, University Medical Center Utrecht, Utrecht, The Netherlands.Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands.Department of Vascular Medicine, University Medical Center Utrecht, Utrecht, The Netherlands.Division of Heart and Lungs, Department of Cardiology, University Medical Center Utrecht, Utrecht, The Netherlands.Department of Vascular Medicine, University Medical Center Utrecht, Utrecht, The Netherlands. Electronic address: F.L.J.visseren@umcutrecht.nl.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

25554536

Citation

van de Woestijne, Anton P., et al. "Effect of Statin Therapy On Incident Type 2 Diabetes Mellitus in Patients With Clinically Manifest Vascular Disease." The American Journal of Cardiology, vol. 115, no. 4, 2015, pp. 441-6.
van de Woestijne AP, van der Graaf Y, Westerink J, et al. Effect of statin therapy on incident type 2 diabetes mellitus in patients with clinically manifest vascular disease. Am J Cardiol. 2015;115(4):441-6.
van de Woestijne, A. P., van der Graaf, Y., Westerink, J., Nathoe, H. M., & Visseren, F. L. (2015). Effect of statin therapy on incident type 2 diabetes mellitus in patients with clinically manifest vascular disease. The American Journal of Cardiology, 115(4), pp. 441-6. doi:10.1016/j.amjcard.2014.11.021.
van de Woestijne AP, et al. Effect of Statin Therapy On Incident Type 2 Diabetes Mellitus in Patients With Clinically Manifest Vascular Disease. Am J Cardiol. 2015 Feb 15;115(4):441-6. PubMed PMID: 25554536.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Effect of statin therapy on incident type 2 diabetes mellitus in patients with clinically manifest vascular disease. AU - van de Woestijne,Anton P, AU - van der Graaf,Yolanda, AU - Westerink,Jan, AU - Nathoe,Hendrik M, AU - Visseren,Frank L J, Y1 - 2014/11/29/ PY - 2014/08/29/received PY - 2014/11/25/revised PY - 2014/11/25/accepted PY - 2015/1/3/entrez PY - 2015/1/3/pubmed PY - 2015/4/8/medline SP - 441 EP - 6 JF - The American journal of cardiology JO - Am. J. Cardiol. VL - 115 IS - 4 N2 - 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. SN - 1879-1913 UR - https://www.unboundmedicine.com/medline/citation/25554536/Effect_of_statin_therapy_on_incident_type_2_diabetes_mellitus_in_patients_with_clinically_manifest_vascular_disease_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0002-9149(14)02162-6 DB - PRIME DP - Unbound Medicine ER -