Statins May Increase the Risk of Diabetes in High-Risk Patients

Initiating statin therapy may modestly increase the risk of incident diabetes mellitus (DM) among adults without DM who are at an increased risk for atherosclerotic cardiovascular disease (ASCVD), according to results of a new study. 

To reach this conclusion, authors of the Kaiser Permanente Cholesterol-Lowering Therapy in High-Risk Adults: Management and Patient Risks (KP CHAMP) study identified 213,289 eligible adults between 2008 and 2010. The patients did not have DM or previous lipid-lowering therapy use but did have cardiovascular (CV) risk factors.

The CV risk factors included known ASCVD, elevated low-density lipoprotein cholesterol (LDL-C) of 190 mg/dl or greater, or LDL-C between 70 and 189 mg/dl and an estimated 10-year ASCVD risk of 7.5% or greater. Incident DM was defined as having 2 or more abnormal tests (ie, A1C of 6.5% or more or a fasting blood glucose of 126 mg/dl or more) or at least 1 abnormal test result plus a new diagnostic code or medication for DM. 

Among the eligible adults, 28,149 of the patients who initiated statins were matched 1:1 with patients who remained off lipid-lowering therapy during follow-up. The 2 groups had the same mean age (67.9 ± 9.4 years) and gender make-up (42.8% women). 

The crude rate (per 100 person years) of incident DM was low (0.55, 95% CI, 0.52-0.59). However, compared with the patients who did not receive lipid-lowering therapy, patients who did receive statins had a marginally higher crude rate of incident DM (0.42, 95% CI, 0.38-0.46 vs 0.69, 95% CI, 0.64-0.74).

Furthermore, statin therapy was associated with a modestly increased risk of incident DM (adjusted hazard ratio 1.17, 95% CI, 1.02-1.34) following additional adjustment.

“In conclusion, in adults without DM at increased ASCVD risk, initiation of statin therapy was independently associated with a modestly higher risk of incident DM,” the researchers wrote.

—Colleen Murphy

Reference:

Go AS, Ambrosy AP, Kheder K, et al; Kaiser Permanente Cholesterol-Lowering Therapy in High-Risk Adults: Management and Patient Risks (KP CHAMP) Study. Statin therapy and risk of incident diabetes mellitus in adults with cardiovascular risk factors. Am J Cardiol. 2020;125(4):534-541. https://doi.org/10.1016/j.amjcard.2019.11.011.