Statins and New-Onset Diabetes Mellitus and Diabetic Complications: A Retrospective Cohort Study of US Healthy Adults

doi:10.1007/s11606-015-3335-1

Observational Study

. 2015 Nov;30(11):1599-610.

doi: 10.1007/s11606-015-3335-1. Epub 2015 Apr 28.

Statins and New-Onset Diabetes Mellitus and Diabetic Complications: A Retrospective Cohort Study of US Healthy Adults

Ishak Mansi^{1

2}, Christopher R Frei^{3

4}, Chen-Pin Wang⁵, Eric M Mortensen^{6

7}

Affiliations

¹ Department of Medicine, VA North Texas Health System, 4500 S. Lancaster Rd #111E, Dallas, TX, USA. Ishak.mansi@va.gov.
² Departments of Medicine and Clinical Sciences, University of Texas Southwestern, Dallas, TX, 75216, USA. Ishak.mansi@va.gov.
³ Pharmacotherapy Division, College of Pharmacy, The University of Texas at Austin, Austin, TX, USA.
⁴ Pharmacotherapy Education and Research Center, School of Medicine, University of Texas Health Science Center, San Antonio, TX, USA.
⁵ University of Texas Health Science Center, San Antonio, TX, USA.
⁶ Department of Medicine, VA North Texas Health System, 4500 S. Lancaster Rd #111E, Dallas, TX, USA.
⁷ Departments of Medicine and Clinical Sciences, University of Texas Southwestern, Dallas, TX, 75216, USA.

PMID: 25917657
PMCID: PMC4617949
DOI: 10.1007/s11606-015-3335-1

Observational Study

Statins and New-Onset Diabetes Mellitus and Diabetic Complications: A Retrospective Cohort Study of US Healthy Adults

Ishak Mansi et al. J Gen Intern Med. 2015 Nov.

. 2015 Nov;30(11):1599-610.

doi: 10.1007/s11606-015-3335-1. Epub 2015 Apr 28.

Authors

Ishak Mansi^{1

2}, Christopher R Frei^{3

4}, Chen-Pin Wang⁵, Eric M Mortensen^{6

7}

Affiliations

¹ Department of Medicine, VA North Texas Health System, 4500 S. Lancaster Rd #111E, Dallas, TX, USA. Ishak.mansi@va.gov.
² Departments of Medicine and Clinical Sciences, University of Texas Southwestern, Dallas, TX, 75216, USA. Ishak.mansi@va.gov.
³ Pharmacotherapy Division, College of Pharmacy, The University of Texas at Austin, Austin, TX, USA.
⁴ Pharmacotherapy Education and Research Center, School of Medicine, University of Texas Health Science Center, San Antonio, TX, USA.
⁵ University of Texas Health Science Center, San Antonio, TX, USA.
⁶ Department of Medicine, VA North Texas Health System, 4500 S. Lancaster Rd #111E, Dallas, TX, USA.
⁷ Departments of Medicine and Clinical Sciences, University of Texas Southwestern, Dallas, TX, 75216, USA.

PMID: 25917657
PMCID: PMC4617949
DOI: 10.1007/s11606-015-3335-1

Abstract

Background: Statin use is associated with increased incidence of diabetes and possibly with increased body weight and reduced exercise capacity. Data on the long-term effects of these associations in healthy adults, however, are very limited. In addition, the relationship between these effects and diabetic complications has not been adequately studied.

Objective: To examine the association between statin use and new-onset diabetes, diabetic complications, and overweight/obesity in a cohort of healthy adults.

Research design: This was a retrospective cohort study.

Participants: Subjects were Tricare beneficiaries who were evaluated between October 1, 2003 and March 1, 2012. Patients were divided into statin users and nonusers.

Intervention: We excluded patients who, at baseline, had a preexisting disease indicative of cardiovascular diseases, any positive element of the Charlson comorbidity index (including diabetes mellitus), or life-limiting chronic diseases. Using 42 baseline characteristics, we generated a propensity score to match statin users and nonusers.

Main measures: Outcomes assessed included new-onset diabetes, diabetic complications, and overweight/obesity.

Key results: A total of 25,970 patients (3982 statin users and 21,988 nonusers) were identified as healthy adults at baseline. Of these, 3351 statins users and 3351 nonusers were propensity score-matched. Statin users had higher odds of new-onset diabetes (odds ratio [OR] 1.87; 95 % confidence interval [95 % CI] 1.67-2.01), diabetes with complications (OR 2.50; 95 % CI 1.88-3.32), and overweight/obesity (OR 1.14; 95 % CI 1.04-1.25). Secondary and sensitivity analyses demonstrated similar findings.

Conclusions: Diabetes, diabetic complications, and overweight/obesity were more commonly diagnosed among statin-users than similar nonusers in a healthy cohort of adults. This study demonstrates that short-term clinical trials might not fully describe the risk/benefit of long-term statin use for primary prevention.

Keywords: Adverse events; Diabetes; Diabetic complications; Observational study; Overweight/obesity; Primary prevention; Satins.

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Comment in

Statins and Diabetes: The Plot Thickens.
Gastaldi G, Philippe J. Gastaldi G, et al. J Gen Intern Med. 2015 Nov;30(11):1572-3. doi: 10.1007/s11606-015-3399-y. J Gen Intern Med. 2015. PMID: 25986140 Free PMC article. No abstract available.
Risk of new-onset diabetes with statin use should not be overemphasised.
Chiang CE, Wang KL. Chiang CE, et al. Evid Based Med. 2015 Dec;20(6):222. doi: 10.1136/ebmed-2015-110229. Epub 2015 Oct 6. Evid Based Med. 2015. PMID: 26442566 No abstract available.

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References

1. Sattar N, Preiss D, Murray HM, et al. Statins and risk of incident diabetes: a collaborative meta-analysis of randomised statin trials. Lancet. 2010;375:735–742. doi: 10.1016/S0140-6736(09)61965-6. - DOI - PubMed
1. Sugiyama T, Tsugawa Y, Tseng CH, Kobayashi Y, Shapiro MF. Different time trends of caloric and fat intake between statin users and nonusers among us adults: gluttony in the time of statins? JAMA Intern Med. 2014;174:1038–1045. doi: 10.1001/jamainternmed.2014.1927. - DOI - PMC - PubMed
1. Redberg RF. Statins and weight gain. JAMA Intern Med. 2014;174:1046. doi: 10.1001/jamainternmed.2014.1994. - DOI - PubMed
1. Nakata M, Nagasaka S, Kusaka I, Matsuoka H, Ishibashi S, Yada T. Effects of statins on the adipocyte maturation and expression of glucose transporter 4 (SLC2A4): implications in glycaemic control. Diabetologia. 2006;49:1881–1892. doi: 10.1007/s00125-006-0269-5. - DOI - PubMed
1. Colhoun HM, Betteridge DJ, Durrington PN, et al. Primary prevention of cardiovascular disease with atorvastatin in type 2 diabetes in the collaborative atorvastatin diabetes study (CARDS): multicentre randomised placebo-controlled trial. Lancet. 2004;364:685–696. doi: 10.1016/S0140-6736(04)16895-5. - DOI - PubMed

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[1] Sattar N, Preiss D, Murray HM, et al. Statins and risk of incident diabetes: a collaborative meta-analysis of randomised statin trials. Lancet. 2010;375:735–742. doi: 10.1016/S0140-6736(09)61965-6. - DOI - PubMed

[2] Sattar N, Preiss D, Murray HM, et al. Statins and risk of incident diabetes: a collaborative meta-analysis of randomised statin trials. Lancet. 2010;375:735–742. doi: 10.1016/S0140-6736(09)61965-6. - DOI - PubMed

[3] Sugiyama T, Tsugawa Y, Tseng CH, Kobayashi Y, Shapiro MF. Different time trends of caloric and fat intake between statin users and nonusers among us adults: gluttony in the time of statins? JAMA Intern Med. 2014;174:1038–1045. doi: 10.1001/jamainternmed.2014.1927. - DOI - PMC - PubMed

[4] Sugiyama T, Tsugawa Y, Tseng CH, Kobayashi Y, Shapiro MF. Different time trends of caloric and fat intake between statin users and nonusers among us adults: gluttony in the time of statins? JAMA Intern Med. 2014;174:1038–1045. doi: 10.1001/jamainternmed.2014.1927. - DOI - PMC - PubMed

[5] Redberg RF. Statins and weight gain. JAMA Intern Med. 2014;174:1046. doi: 10.1001/jamainternmed.2014.1994. - DOI - PubMed

[6] Redberg RF. Statins and weight gain. JAMA Intern Med. 2014;174:1046. doi: 10.1001/jamainternmed.2014.1994. - DOI - PubMed

[7] Nakata M, Nagasaka S, Kusaka I, Matsuoka H, Ishibashi S, Yada T. Effects of statins on the adipocyte maturation and expression of glucose transporter 4 (SLC2A4): implications in glycaemic control. Diabetologia. 2006;49:1881–1892. doi: 10.1007/s00125-006-0269-5. - DOI - PubMed

[8] Nakata M, Nagasaka S, Kusaka I, Matsuoka H, Ishibashi S, Yada T. Effects of statins on the adipocyte maturation and expression of glucose transporter 4 (SLC2A4): implications in glycaemic control. Diabetologia. 2006;49:1881–1892. doi: 10.1007/s00125-006-0269-5. - DOI - PubMed

[9] Colhoun HM, Betteridge DJ, Durrington PN, et al. Primary prevention of cardiovascular disease with atorvastatin in type 2 diabetes in the collaborative atorvastatin diabetes study (CARDS): multicentre randomised placebo-controlled trial. Lancet. 2004;364:685–696. doi: 10.1016/S0140-6736(04)16895-5. - DOI - PubMed

[10] Colhoun HM, Betteridge DJ, Durrington PN, et al. Primary prevention of cardiovascular disease with atorvastatin in type 2 diabetes in the collaborative atorvastatin diabetes study (CARDS): multicentre randomised placebo-controlled trial. Lancet. 2004;364:685–696. doi: 10.1016/S0140-6736(04)16895-5. - DOI - PubMed

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Statins and New-Onset Diabetes Mellitus and Diabetic Complications: A Retrospective Cohort Study of US Healthy Adults

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Statins and New-Onset Diabetes Mellitus and Diabetic Complications: A Retrospective Cohort Study of US Healthy Adults

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