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J Gen Intern Med. 2016 May;31(5):502-8. doi: 10.1007/s11606-015-3583-0. Epub 2016 Feb 5.

Statin Use, Diabetes Incidence and Overall Mortality in Normoglycemic and Impaired Fasting Glucose Patients.

Author information

1
Department of Medicine, Division of Endocrinology, Mayo Clinic, Rochester, MN, USA.
2
Institute for Health Informatics, University of Minnesota, Minneapolis, MN, USA.
3
Department of Health Sciences Research, Division of Biomedical Statistics & Informatics, Mayo Clinic, Rochester, MN, USA.
4
Department of Research, Olmsted Medical Center, Rochester, MN, USA.
5
Department of Health Sciences Research, Division of Epidemiology, Mayo Clinic, Rochester, MN, USA.
6
Department of Medicine, Division of General Internal Medicine, Mayo Clinic, Rochester, MN, USA. caraballo.pedro@mayo.edu.
7
Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA. caraballo.pedro@mayo.edu.

Abstract

BACKGROUND:

The association between the use of statins and the risk of diabetes and increased mortality within the same population has been a source of controversy, and may underestimate the value of statins for patients at risk.

OBJECTIVE:

We aimed to assess whether statin use increases the risk of developing diabetes or affects overall mortality among normoglycemic patients and patients with impaired fasting glucose (IFG).

DESIGN AND PARTICIPANTS:

Observational cohort study of 13,508 normoglycemic patients (n = 4460; 33% taking statins) and 4563 IFG patients (n = 1865; 41% taking statin) among residents of Olmsted County, Minnesota, with clinical data in the Mayo Clinic electronic medical record and at least one outpatient fasting glucose test between 1999 and 2004. Demographics, vital signs, tobacco use, laboratory results, medications and comorbidities were obtained by electronic search for the period 1999-2004. Results were analyzed by Cox proportional hazards models, and the risk of incident diabetes and mortality were analyzed by survival curves using the Kaplan-Meier method.

MAIN MEASURES:

The main endpoints were new clinical diagnosis of diabetes mellitus and total mortality.

KEY RESULTS:

After a mean of 6 years of follow-up, statin use was found to be associated with an increased risk of incident diabetes in the normoglycemic (HR 1.19; 95% CI, 1.05 to 1.35; p = 0.007) and IFG groups (HR 1.24; 95%CI, 1.11 to 1.38; p = 0.0001). At the same time, overall mortality decreased in both normoglycemic (HR 0.70; 95% CI, 0.66 to 0.80; p < 0.0001) and IFG patients (HR 0.77, 95% CI, 0.64 to 0.91; p = 0.0029) with statin use.

CONCLUSION:

In general, recommendations for statin use should not be affected by concerns over an increased risk of developing diabetes, since the benefit of reduced mortality clearly outweighs this small (19-24%) risk.

KEYWORDS:

diabetes; impaired fasting glucose; mortality; prediabetes; statins

PMID:
26850412
PMCID:
PMC4835368
DOI:
10.1007/s11606-015-3583-0
[Indexed for MEDLINE]
Free PMC Article

Conflict of interest statement

The authors declare that they do not have a conflict of interest. All authors contributed to the study design, review of the data, results and analysis, and writing of the manuscript. PJC, GS and SSC designed and supervised the electronic data collection. GS and SSC performed the statistical analysis.

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