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Statins worsen glycemic control of T2DM in target LDL-c level and LDL-c reduction dependent manners: a meta-analysis.
Expert Opin Pharmacother 2016; 17(14):1839-49EO

Abstract

OBJECTIVE

Recent studies demonstrated that a low target low-density lipoprotein cholesterol (LDL-c) level, high LDL-c reduction and high dose of statin therapy increased incident diabetes. This study aimed to explore how statin therapy influences glycemic control in type 2 diabetes mellitus (T2DM).

METHODS

Medline, Embase, and Cochrane Central were searched for randomized control trials inT2DM. Trials with target LDL-c levels of ≤2.6 mmol/L or LDL-c reduction of ≥30% were analyzed. Then, we calculated mean differences in glycosylated hemoglobin (HbA1c) and fasting blood glucose via stratified LDL-c level, relative LDL-c reduction and statin dose.

RESULTS

In total, trials involving 6,875 participants (3,619 statins, 3,256 controls) were included. Meta-analysis showed that detrimental effect of intensive LDL-c lowering statin therapy on HbA1c (SMD 0.10%; 95% CI 0.05, 0.15; p = 0.000) was more severe than all statin trials analyzed together (SMD 0.07%; 95% CI 0.02, 0.12; p = 0.005). Stratified analyses revealed that the effects on HbA1c became increasingly significant as target LDL-c level decreased and LDL-c reduction increased. Low baseline LDL-c and endpoint LDL-c levels were risk factors involved in increasing HbA1c level during statin therapy.

CONCLUSIONS

Statin therapy worsens the glycemic control of T2DM in target LDL-c level and LDL-c reduction dependent manners.

Authors+Show Affiliations

a Department of Endocrinology , The Affiliated ZhongDa Hospital of Southeast University , Nanjing , PR China. b Medical School of Southeast University , Nanjing , PR China.a Department of Endocrinology , The Affiliated ZhongDa Hospital of Southeast University , Nanjing , PR China.a Department of Endocrinology , The Affiliated ZhongDa Hospital of Southeast University , Nanjing , PR China.a Department of Endocrinology , The Affiliated ZhongDa Hospital of Southeast University , Nanjing , PR China.a Department of Endocrinology , The Affiliated ZhongDa Hospital of Southeast University , Nanjing , PR China.a Department of Endocrinology , The Affiliated ZhongDa Hospital of Southeast University , Nanjing , PR China.a Department of Endocrinology , The Affiliated ZhongDa Hospital of Southeast University , Nanjing , PR China.a Department of Endocrinology , The Affiliated ZhongDa Hospital of Southeast University , Nanjing , PR China.a Department of Endocrinology , The Affiliated ZhongDa Hospital of Southeast University , Nanjing , PR China.

Pub Type(s)

Journal Article
Meta-Analysis
Review

Language

eng

PubMed ID

27488607

Citation

Cai, Rongrong, et al. "Statins Worsen Glycemic Control of T2DM in Target LDL-c Level and LDL-c Reduction Dependent Manners: a Meta-analysis." Expert Opinion On Pharmacotherapy, vol. 17, no. 14, 2016, pp. 1839-49.
Cai R, Yuan Y, Sun J, et al. Statins worsen glycemic control of T2DM in target LDL-c level and LDL-c reduction dependent manners: a meta-analysis. Expert Opin Pharmacother. 2016;17(14):1839-49.
Cai, R., Yuan, Y., Sun, J., Xia, W., Huang, R., Tian, S., ... Wang, S. (2016). Statins worsen glycemic control of T2DM in target LDL-c level and LDL-c reduction dependent manners: a meta-analysis. Expert Opinion On Pharmacotherapy, 17(14), pp. 1839-49. doi:10.1080/14656566.2016.1220539.
Cai R, et al. Statins Worsen Glycemic Control of T2DM in Target LDL-c Level and LDL-c Reduction Dependent Manners: a Meta-analysis. Expert Opin Pharmacother. 2016;17(14):1839-49. PubMed PMID: 27488607.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Statins worsen glycemic control of T2DM in target LDL-c level and LDL-c reduction dependent manners: a meta-analysis. AU - Cai,Rongrong, AU - Yuan,Yang, AU - Sun,Jie, AU - Xia,Wenqing, AU - Huang,Rong, AU - Tian,Sai, AU - Dong,Xue, AU - Shen,Yanjue, AU - Wang,Shaohua, Y1 - 2016/08/12/ PY - 2016/8/5/entrez PY - 2016/8/5/pubmed PY - 2017/3/11/medline KW - Diabetes KW - HbA1c KW - LDL-c KW - meta-analysis KW - statins SP - 1839 EP - 49 JF - Expert opinion on pharmacotherapy JO - Expert Opin Pharmacother VL - 17 IS - 14 N2 - OBJECTIVE: Recent studies demonstrated that a low target low-density lipoprotein cholesterol (LDL-c) level, high LDL-c reduction and high dose of statin therapy increased incident diabetes. This study aimed to explore how statin therapy influences glycemic control in type 2 diabetes mellitus (T2DM). METHODS: Medline, Embase, and Cochrane Central were searched for randomized control trials inT2DM. Trials with target LDL-c levels of ≤2.6 mmol/L or LDL-c reduction of ≥30% were analyzed. Then, we calculated mean differences in glycosylated hemoglobin (HbA1c) and fasting blood glucose via stratified LDL-c level, relative LDL-c reduction and statin dose. RESULTS: In total, trials involving 6,875 participants (3,619 statins, 3,256 controls) were included. Meta-analysis showed that detrimental effect of intensive LDL-c lowering statin therapy on HbA1c (SMD 0.10%; 95% CI 0.05, 0.15; p = 0.000) was more severe than all statin trials analyzed together (SMD 0.07%; 95% CI 0.02, 0.12; p = 0.005). Stratified analyses revealed that the effects on HbA1c became increasingly significant as target LDL-c level decreased and LDL-c reduction increased. Low baseline LDL-c and endpoint LDL-c levels were risk factors involved in increasing HbA1c level during statin therapy. CONCLUSIONS: Statin therapy worsens the glycemic control of T2DM in target LDL-c level and LDL-c reduction dependent manners. SN - 1744-7666 UR - https://www.unboundmedicine.com/medline/citation/27488607/Statins_worsen_glycemic_control_of_T2DM_in_target_LDL_c_level_and_LDL_c_reduction_dependent_manners:_a_meta_analysis_ L2 - http://www.tandfonline.com/doi/full/10.1080/14656566.2016.1220539 DB - PRIME DP - Unbound Medicine ER -