Statins raise diabetes risk in adults with CV risk factors

  • Go AS & al.
  • Am J Cardiol
  • 19/11/2019

  • Miriam Tucker
  • Clinical Essentials
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Takeaway

  • Statin therapy initiation is independently associated with a modestly higher adjusted rate of incident diabetes overall and among those treated with low-potency statin therapy compared with no statins.

Why this matters

  • The association between statins and diabetes remains controversial.

Study design

  • The Kaiser Permanente CHAMP Study identified 213,289 adults without baseline diabetes who had cardiovascular risk factors conferring an estimated 10-year atherosclerotic cardiovascular disease (ASCVD) risk ≥7.5% and no previous lipid-lowering therapy (LLT) between 2008 and 2010.
  • Matched at-risk groups with and without statin exposure were followed, with 28,149 participants each.  
  • Funding: Sanofi; Regeneron Pharmaceuticals.

Key results

  • Overall unadjusted annual incident diabetes rate was 0.55 (95% CI, 0.52-0.59) per 100 person-years.
  • Rate was higher in statin initiators (0.69 [95% CI, 0.64-0.74] per 100 person-years) vs matched patients with no LLT (0.42 [95% CI, 0.38-0.46] per 100 person-years).
  • In multivariable models with adjustment for time-updated confounders, statin therapy was associated with a modestly increased risk for incident diabetes vs no LLT use: adjusted HR, 1.17 (95% CI, 1.02-1.34).
  • Similar results were found in sensitivity analysis comparing exposure to low-potency statin therapy vs no LLT (n=25,999 each; adjusted HR, 1.22; 95% CI, 1.06-1.40).

Limitations

  • Inadequate statistical power to address high-potency statin effect.
  • ASCVD prevalence differed at baseline despite matching.
  • Potential residual confounding via diabetes screening.