Rosuvastatin and Atorvastatin: Comparative Effects on Glucose Metabolism in Non-Diabetic Patients with Dyslipidaemia

Abstract

The ever increasing interventional CVD outcome studies have resulted in statins being an essential factor of cardiovascular prevention strategies. The JUPITER study in 2008, despite reducing CVD and overall mortality, highlighted an increase in new onset diabetes in the rosuvastatin treated arm. Since then there have been many meta-analyses of the RCTs and the largest carried out by Sattar et al showed a significant increase in the incidence of diabetes during the trials. The findings from the individual studies when comparing the different statins were less clear. A higher statin dosage and risk factors associated with diabetes appeared to predict this phenomenon. There have been many studies investigating the effects of statins on glycaemic control, but again no clear conclusion is apparent. Despite the increase in new onset diabetes observed, the risk is clearly out-weighed by the CVD benefits observed in nearly all the statin trials. Thus, no change is required to any of the prevention guidelines regarding statins. However, it may be prudent to monitor glycaemic control after commencing statin therapy. This review will focus on atorvastatin which is the most widely used statin worldwide and rosuvastatin which is the most efficacious. This will be against a background of the effects of other statins on glucose metabolism in non-diabetic patients.

The association of sex hormone‐binding globulin with mortality is mediated by age and testosterone in men with type 2 diabetes

“…We found a clear and significant association between SHBG level and age, and Fig. Further, a negative correlation between SHBG and statin use was observed, a finding compatible with reports that statin use is associated with increased risk of T2DM (Sattar et al, 2010;Abbas et al, 2012). As expected, we found associations between SHBG and relevant variables; significant negative associations were found with HbA1c, BMI, and TG while the association with HDL-c was positive.…”

An Update on the Benefits and Risks of Rosuvastatin Therapy

“…58 The FDA assessed the risk of DM associated with statin use and concluded that the cardiovascular benefits of statin therapy outweigh the small increased risk of DM. 45 As reviewed by Abbas et al, 56 this finding is supported by data indicating that 37 cardiovascular events will be prevented for every 1000 patients treated for 4.2 years with a statin for secondary prevention. Similarly, Sampson et al 59 provided recommendations based on a data review, and also reported that the benefits of statins in patients with DM are independent of the type of DM, lipid profile, history of vascular disease, or patient baseline characteristics.…”

“…55 However, these differential effects may depend on the baseline characteristics of patients and the dose of statin used. 56 The risk of new-onset DM was also assessed in an Irish population, in which statin prescribing is among the highest in Europe. This retrospective cohort study assessed the presence of subsequent prescriptions of antidiabetic medications.…”

Differential Impact of Statin on New-Onset Diabetes in Different Age Groups: A Population-Based Case-Control Study in Women from an Asian Country

“…Exposure to higher doses of statin resulted in higher risks of NOD [7], [9],[22]. Many mechanisms for statin-related DM have been proposed but this is still a controversial issue [28]. Xia et.…”