Statins and risk of incident diabetes: a collaborative meta-analysis of randomised statin trials.
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Authors
Sattar, NaveedPreiss, David
Murray, Heather M
Welsh, Paul
Buckley, Brendan M
de Craen, Anton J M
Seshasai, Sreenivasa Rao Kondapally
McMurray, John J
Freeman, Dilys J
Jukema, J Wouter
Macfarlane, Peter W
Packard, Chris J
Stott, David J
Westendorp, Rudi G
Shepherd, James
Davis, Barry R
Pressel, Sara L
Marchioli, Roberto
Marfisi, Rosa Maria
Maggioni, Aldo P
Tavazzi, Luigi
Tognoni, Gianni
Kjekshus, John
Pedersen, Terje R
Cook, Thomas J
Gotto, Antonio M
Clearfield, Michael B
Downs, John R
Nakamura, Haruo
Ohashi, Yasuo
Mizuno, Kyoichi
Ray, Kausik K
Ford, Ian
Affiliation
British Heart Foundation Glasgow Cardiovascular Research Centre, University of Glasgow, Glasgow, UK. nsattar@clinmed.gla.ac.ukIssue Date
2010-02-27MeSH
Age DistributionAge Factors
Aged
Anticholesteremic Agents
Cardiovascular Diseases
Diabetes Mellitus, Type 2
Female
Humans
Hydroxymethylglutaryl-CoA Reductase Inhibitors
Male
Middle Aged
Randomized Controlled Trials as Topic
Risk Factors
Treatment Outcome
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Statins and risk of incident diabetes: a collaborative meta-analysis of randomised statin trials. 2010, 375 (9716):735-42 LancetPublisher
ElsevierJournal
LancetDOI
10.1016/S0140-6736(09)61965-6PubMed ID
20167359Abstract
Trials of statin therapy have had conflicting findings on the risk of development of diabetes mellitus in patients given statins. We aimed to establish by a meta-analysis of published and unpublished data whether any relation exists between statin use and development of diabetes.We searched Medline, Embase, and the Cochrane Central Register of Controlled Trials from 1994 to 2009, for randomised controlled endpoint trials of statins. We included only trials with more than 1000 patients, with identical follow-up in both groups and duration of more than 1 year. We excluded trials of patients with organ transplants or who needed haemodialysis. We used the I(2) statistic to measure heterogeneity between trials and calculated risk estimates for incident diabetes with random-effect meta-analysis.
We identified 13 statin trials with 91 140 participants, of whom 4278 (2226 assigned statins and 2052 assigned control treatment) developed diabetes during a mean of 4 years. Statin therapy was associated with a 9% increased risk for incident diabetes (odds ratio [OR] 1.09; 95% CI 1.02-1.17), with little heterogeneity (I(2)=11%) between trials. Meta-regression showed that risk of development of diabetes with statins was highest in trials with older participants, but neither baseline body-mass index nor change in LDL-cholesterol concentrations accounted for residual variation in risk. Treatment of 255 (95% CI 150-852) patients with statins for 4 years resulted in one extra case of diabetes.
Statin therapy is associated with a slightly increased risk of development of diabetes, but the risk is low both in absolute terms and when compared with the reduction in coronary events. Clinical practice in patients with moderate or high cardiovascular risk or existing cardiovascular disease should not change.
None.
Item Type
ArticleLanguage
enISSN
1474-547Xae974a485f413a2113503eed53cd6c53
10.1016/S0140-6736(09)61965-6
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