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J Gen Intern Med. 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.

Author information

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.

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

PMID:
25917657
PMCID:
PMC4617949
DOI:
10.1007/s11606-015-3335-1
[Indexed for MEDLINE]
Free PMC Article
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