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Statin Use, Diabetes Incidence and Overall Mortality in Normoglycemic and Impaired Fasting Glucose Patients.
J Gen Intern Med 2016; 31(5):502-8JG

Abstract

BACKGROUND

The association between the use of statins and the risk of diabetes and increased mortality within the same population has been a source of controversy, and may underestimate the value of statins for patients at risk.

OBJECTIVE

We aimed to assess whether statin use increases the risk of developing diabetes or affects overall mortality among normoglycemic patients and patients with impaired fasting glucose (IFG).

DESIGN AND PARTICIPANTS

Observational cohort study of 13,508 normoglycemic patients (n = 4460; 33% taking statins) and 4563 IFG patients (n = 1865; 41% taking statin) among residents of Olmsted County, Minnesota, with clinical data in the Mayo Clinic electronic medical record and at least one outpatient fasting glucose test between 1999 and 2004. Demographics, vital signs, tobacco use, laboratory results, medications and comorbidities were obtained by electronic search for the period 1999-2004. Results were analyzed by Cox proportional hazards models, and the risk of incident diabetes and mortality were analyzed by survival curves using the Kaplan-Meier method.

MAIN MEASURES

The main endpoints were new clinical diagnosis of diabetes mellitus and total mortality.

KEY RESULTS

After a mean of 6 years of follow-up, statin use was found to be associated with an increased risk of incident diabetes in the normoglycemic (HR 1.19; 95% CI, 1.05 to 1.35; p = 0.007) and IFG groups (HR 1.24; 95%CI, 1.11 to 1.38; p = 0.0001). At the same time, overall mortality decreased in both normoglycemic (HR 0.70; 95% CI, 0.66 to 0.80; p < 0.0001) and IFG patients (HR 0.77, 95% CI, 0.64 to 0.91; p = 0.0029) with statin use.

CONCLUSION

In general, recommendations for statin use should not be affected by concerns over an increased risk of developing diabetes, since the benefit of reduced mortality clearly outweighs this small (19-24%) risk.

Authors+Show Affiliations

Department of Medicine, Division of Endocrinology, Mayo Clinic, Rochester, MN, USA.Institute for Health Informatics, University of Minnesota, Minneapolis, MN, USA.Department of Health Sciences Research, Division of Biomedical Statistics & Informatics, Mayo Clinic, Rochester, MN, USA.Department of Research, Olmsted Medical Center, Rochester, MN, USA.Department of Health Sciences Research, Division of Epidemiology, Mayo Clinic, Rochester, MN, USA.Department of Medicine, Division of General Internal Medicine, Mayo Clinic, Rochester, MN, USA. caraballo.pedro@mayo.edu. Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA. caraballo.pedro@mayo.edu.

Pub Type(s)

Journal Article
Observational Study
Research Support, N.I.H., Extramural

Language

eng

PubMed ID

26850412

Citation

Castro, M Regina, et al. "Statin Use, Diabetes Incidence and Overall Mortality in Normoglycemic and Impaired Fasting Glucose Patients." Journal of General Internal Medicine, vol. 31, no. 5, 2016, pp. 502-8.
Castro MR, Simon G, Cha SS, et al. Statin Use, Diabetes Incidence and Overall Mortality in Normoglycemic and Impaired Fasting Glucose Patients. J Gen Intern Med. 2016;31(5):502-8.
Castro, M. R., Simon, G., Cha, S. S., Yawn, B. P., Melton, L. J., & Caraballo, P. J. (2016). Statin Use, Diabetes Incidence and Overall Mortality in Normoglycemic and Impaired Fasting Glucose Patients. Journal of General Internal Medicine, 31(5), pp. 502-8. doi:10.1007/s11606-015-3583-0.
Castro MR, et al. Statin Use, Diabetes Incidence and Overall Mortality in Normoglycemic and Impaired Fasting Glucose Patients. J Gen Intern Med. 2016;31(5):502-8. PubMed PMID: 26850412.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Statin Use, Diabetes Incidence and Overall Mortality in Normoglycemic and Impaired Fasting Glucose Patients. AU - Castro,M Regina, AU - Simon,Gyorgy, AU - Cha,Stephen S, AU - Yawn,Barbara P, AU - Melton,L Joseph,3rd AU - Caraballo,Pedro J, Y1 - 2016/02/05/ PY - 2015/04/30/received PY - 2015/12/16/accepted PY - 2015/09/18/revised PY - 2016/2/7/entrez PY - 2016/2/7/pubmed PY - 2017/1/10/medline KW - diabetes KW - impaired fasting glucose KW - mortality KW - prediabetes KW - statins SP - 502 EP - 8 JF - Journal of general internal medicine JO - J Gen Intern Med VL - 31 IS - 5 N2 - BACKGROUND: The association between the use of statins and the risk of diabetes and increased mortality within the same population has been a source of controversy, and may underestimate the value of statins for patients at risk. OBJECTIVE: We aimed to assess whether statin use increases the risk of developing diabetes or affects overall mortality among normoglycemic patients and patients with impaired fasting glucose (IFG). DESIGN AND PARTICIPANTS: Observational cohort study of 13,508 normoglycemic patients (n = 4460; 33% taking statins) and 4563 IFG patients (n = 1865; 41% taking statin) among residents of Olmsted County, Minnesota, with clinical data in the Mayo Clinic electronic medical record and at least one outpatient fasting glucose test between 1999 and 2004. Demographics, vital signs, tobacco use, laboratory results, medications and comorbidities were obtained by electronic search for the period 1999-2004. Results were analyzed by Cox proportional hazards models, and the risk of incident diabetes and mortality were analyzed by survival curves using the Kaplan-Meier method. MAIN MEASURES: The main endpoints were new clinical diagnosis of diabetes mellitus and total mortality. KEY RESULTS: After a mean of 6 years of follow-up, statin use was found to be associated with an increased risk of incident diabetes in the normoglycemic (HR 1.19; 95% CI, 1.05 to 1.35; p = 0.007) and IFG groups (HR 1.24; 95%CI, 1.11 to 1.38; p = 0.0001). At the same time, overall mortality decreased in both normoglycemic (HR 0.70; 95% CI, 0.66 to 0.80; p < 0.0001) and IFG patients (HR 0.77, 95% CI, 0.64 to 0.91; p = 0.0029) with statin use. CONCLUSION: In general, recommendations for statin use should not be affected by concerns over an increased risk of developing diabetes, since the benefit of reduced mortality clearly outweighs this small (19-24%) risk. SN - 1525-1497 UR - https://www.unboundmedicine.com/medline/citation/26850412/Statin_Use_Diabetes_Incidence_and_Overall_Mortality_in_Normoglycemic_and_Impaired_Fasting_Glucose_Patients_ L2 - https://dx.doi.org/10.1007/s11606-015-3583-0 DB - PRIME DP - Unbound Medicine ER -