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