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Impact of statins on risk of new onset diabetes mellitus: a population-based cohort study using the Korean National Health Insurance claims database.
Ther Clin Risk Manag. 2016; 12:1533-1543.TC

Abstract

Statin therapy is beneficial in reducing cardiovascular events and mortalities in patients with atherosclerotic cardiovascular diseases. Yet, there have been concerns of increased risk of diabetes with statin use. This study was aimed to evaluate the association between statins and new onset diabetes mellitus (NODM) in patients with ischemic heart disease (IHD) utilizing the Korean Health Insurance Review and Assessment Service claims database. Among adult patients with preexisting IHD, new statin users and matched nonstatin users were identified on a 1:1 ratio using proportionate stratified random sampling by sex and age. They were subsequently propensity score matched further with age and comorbidities to reduce the selection bias. Overall incidence rates, cumulative rates and hazard ratios (HRs) between statin use and occurrence of NODM were estimated. The subgroup analyses were performed according to sex, age groups, and the individual agents and intensities of statins. A total of 156,360 patients (94,370 in the statin users and 61,990 in the nonstatin users) were included in the analysis. The incidence rates of NODM were 7.8% and 4.8% in the statin users and nonstatin users, respectively. The risk of NODM was higher among statin users (crude HR 2.01, 95% confidence interval [CI] 1.93-2.10; adjusted HR 1.84, 95% CI 1.63-2.09). Pravastatin had the lowest risk (adjusted HR 1.54, 95% CI 1.32-1.81) while those who were exposed to more than one statin were at the highest risk of NODM (adjusted HR 2.17, 95% CI 1.93-2.37). It has been concluded that all statins are associated with the risk of NODM in patients with IHD, and it is believed that our study would contribute to a better understanding of statin and NODM association by analyzing statin use in the real-world setting. Periodic screening and monitoring for diabetes are warranted during prolonged statin therapy in patients with IHD.

Authors+Show Affiliations

Division of Clinical Pharmacy, College of Pharmacy, Ajou University, Suwon, South Korea.Division of Clinical Pharmacy, College of Pharmacy, Ajou University, Suwon, South Korea.Division of Clinical Pharmacy, College of Pharmacy, Ajou University, Suwon, South Korea.Department of Cardiology, School of Medicine, Ajou University, Suwon, South Korea.Department of Biomedical Informatics, School of Medicine, Ajou University, Suwon, South Korea.Division of Pharmaceutical Sciences, College of Pharmacy, The Catholic University of Korea, Bucheon, South Korea.Division of Pharmaceutical Sciences, College of Pharmacy, The Catholic University of Korea, Bucheon, South Korea.Division of Biomedical Informatics, College of Medicine, Seoul National University, Seoul, South Korea.Division of Biomedical Informatics, College of Medicine, Seoul National University, Seoul, South Korea.Division of Clinical Pharmacy, College of Pharmacy, Ajou University, Suwon, South Korea.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

27785041

Citation

Lee, Jimin, et al. "Impact of Statins On Risk of New Onset Diabetes Mellitus: a Population-based Cohort Study Using the Korean National Health Insurance Claims Database." Therapeutics and Clinical Risk Management, vol. 12, 2016, pp. 1533-1543.
Lee J, Noh Y, Shin S, et al. Impact of statins on risk of new onset diabetes mellitus: a population-based cohort study using the Korean National Health Insurance claims database. Ther Clin Risk Manag. 2016;12:1533-1543.
Lee, J., Noh, Y., Shin, S., Lim, H. S., Park, R. W., Bae, S. K., Oh, E., Kim, G. J., Kim, J. H., & Lee, S. (2016). Impact of statins on risk of new onset diabetes mellitus: a population-based cohort study using the Korean National Health Insurance claims database. Therapeutics and Clinical Risk Management, 12, 1533-1543.
Lee J, et al. Impact of Statins On Risk of New Onset Diabetes Mellitus: a Population-based Cohort Study Using the Korean National Health Insurance Claims Database. Ther Clin Risk Manag. 2016;12:1533-1543. PubMed PMID: 27785041.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Impact of statins on risk of new onset diabetes mellitus: a population-based cohort study using the Korean National Health Insurance claims database. AU - Lee,Jimin, AU - Noh,Yoojin, AU - Shin,Sooyoung, AU - Lim,Hong-Seok, AU - Park,Rae Woong, AU - Bae,Soo Kyung, AU - Oh,Euichaul, AU - Kim,Grace Juyun, AU - Kim,Ju Han, AU - Lee,Sukhyang, Y1 - 2016/10/11/ PY - 2016/10/28/pubmed PY - 2016/10/28/medline PY - 2016/10/28/entrez KW - Atorvastatin KW - Fluvastatin KW - IHD KW - Ischemic heart disease KW - Lovastatin KW - NODM KW - Pitavastatin KW - Pravastatin KW - Rosuvastatin KW - Simvastatin KW - new onset diabetes mellitus SP - 1533 EP - 1543 JF - Therapeutics and clinical risk management JO - Ther Clin Risk Manag VL - 12 N2 - Statin therapy is beneficial in reducing cardiovascular events and mortalities in patients with atherosclerotic cardiovascular diseases. Yet, there have been concerns of increased risk of diabetes with statin use. This study was aimed to evaluate the association between statins and new onset diabetes mellitus (NODM) in patients with ischemic heart disease (IHD) utilizing the Korean Health Insurance Review and Assessment Service claims database. Among adult patients with preexisting IHD, new statin users and matched nonstatin users were identified on a 1:1 ratio using proportionate stratified random sampling by sex and age. They were subsequently propensity score matched further with age and comorbidities to reduce the selection bias. Overall incidence rates, cumulative rates and hazard ratios (HRs) between statin use and occurrence of NODM were estimated. The subgroup analyses were performed according to sex, age groups, and the individual agents and intensities of statins. A total of 156,360 patients (94,370 in the statin users and 61,990 in the nonstatin users) were included in the analysis. The incidence rates of NODM were 7.8% and 4.8% in the statin users and nonstatin users, respectively. The risk of NODM was higher among statin users (crude HR 2.01, 95% confidence interval [CI] 1.93-2.10; adjusted HR 1.84, 95% CI 1.63-2.09). Pravastatin had the lowest risk (adjusted HR 1.54, 95% CI 1.32-1.81) while those who were exposed to more than one statin were at the highest risk of NODM (adjusted HR 2.17, 95% CI 1.93-2.37). It has been concluded that all statins are associated with the risk of NODM in patients with IHD, and it is believed that our study would contribute to a better understanding of statin and NODM association by analyzing statin use in the real-world setting. Periodic screening and monitoring for diabetes are warranted during prolonged statin therapy in patients with IHD. SN - 1176-6336 UR - https://www.unboundmedicine.com/medline/citation/27785041/Impact_of_statins_on_risk_of_new_onset_diabetes_mellitus:_a_population_based_cohort_study_using_the_Korean_National_Health_Insurance_claims_database_ L2 - https://dx.doi.org/10.2147/TCRM.S117150 DB - PRIME DP - Unbound Medicine ER -
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