Statins dose-dependently increase diabetes risk

July 07, 2011
Statins dose-dependently increase diabetes risk
By
Springer
MedWire News: Statin therapy appears to dose-dependently increase the risk for diabetes whilst reducing the risk for cardiovascular events, results of a meta-analysis published in JAMA suggest.

It is well established that statin treatment reduces the risk for cardiovascular events in those with and without a history of diabetes, and that higher statin doses have a more beneficial effect on the risk for cardiovascular events than moderate statin doses.

However, a meta-analysis of over 91,000 patients recently published by Sattar et al in TheLancet suggested that the risk for developing diabetes was 9% higher over a 4-year period in those treated with statins than in those given placebo or standard care, write David Preiss (University of Glasgow, Scotland, UK) and colleagues.

Similarly, three large trials have recently suggested that intensive versus moderate statin therapy is associated with an increased risk for diabetes, the authors write.

To investigate further, Preiss and team performed a systematic review of randomized controlled trials that compared intense and moderate dose statin therapy in more than 1000 patients for at least 1 year.

The analysis included data from trials identified through traditional academic databases such as MEDLINE as well as unpublished data from fellow investigators.

A total of five trials including 32,752 patients who did not have diabetes when recruited were identified and analysis revealed that the risk of developing diabetes was 1.12 times greater in those receiving intensive statin therapy than in those receiving moderate statin therapy.

As expected, intensive statin therapy was associated with decreased risk for cardiovascular events compared with moderate therapy, giving a hazard ratio of 0.84.

In absolute terms this suggested that there was one additional case of diabetes for every 498 patients given intensive statin therapy for 1 year, and one less cardiovascular event for every 155 patients treated with intensive statin therapy for 1 year.

Discussing the limitations of their study, the authors say that they "cannot exclude the possibility that intensive statin therapy may have caused more adverse effects and therefore led to differences in routine clinical care between those treated with intensive- and moderate-dose regimens, resulting in detection bias."

Nevertheless, the current findings "extend earlier findings of an increased incidence of diabetes with statin therapy by providing evidence of a dose-dependent association," the authors conclude.

MedWire (http://www.medwire-news.md/ ) is an independent clinical news service provided by Springer Healthcare Limited. © Springer Healthcare Ltd; 2011

By Philip Ford