Statin use and risk of new-onset diabetes: A meta-analysis of observational studies

Casula, Manuela; Mozzanica, Francesco; Scotti, Lorenza; Tragni, Elena; Pirillo, Angela; Corrao, Giovanni; Catapano, Alberico L.

doi:10.1016/j.numecd.2017.03.001

Cited by 124 publications

(96 citation statements)

References 62 publications

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“…These findings are of clinical interest, because on the one hand, they provide evidence in support of the generalizability of the conclusion shown in the general population to the diseased individuals, especially when considering the consistent results observed in patients with erectile dysfunction, as in statin users . On the other hand, they may help ameliorate the ongoing uncertainties about the increased risk of type 2 diabetes resulting from statin use , in particular when statins are recommended for the primary prevention of cardiovascular events, if approaches designed to improve CRF, such as attending exercise training or increasing physical activity , are implemented.…”

Section: Discussionsupporting

confidence: 55%

“…Moreover, several studies with updated outcomes using longer follow‐up data in the general population, or specifically focused on individuals taking statins, have been published since 2015 . Yet concerns remain as to whether a similar association exists in statin users who are vulnerable to the development of type 2 diabetes and whether a higher level of CRF would attenuate or eliminate the increased risk of type 2 diabetes in statin users compared with individuals not taking statins. In addition to statin use, weight loss has long been considered a cornerstone in the management of cardiometabolic disorders .…”

Section: Introductionmentioning

confidence: 99%

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Association Between Cardiorespiratory Fitness and Risk of Type 2 Diabetes: A Meta‐Analysis

Qiu

Cai

Yang

et al. 2019

Obesity

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Objective: This meta-analysis aimed to (1) quantify the association of cardiorespiratory fitness (CRF) with type 2 diabetes risk in the general population and statin users and (2) investigate the joint effects of CRF and fatness with type 2 diabetes risk. Methods: Databases were searched for cohort studies reporting the association between CRF and type 2 diabetes risk. Summary hazard ratios (HRs) were obtained using random-effects models. Results: Fifteen studies were included. The HRs of type 2 diabetes for every 1-metabolic equivalent increase in CRF were 0.90 (95% CI: 0.86-0.94) for the general population and 0.92 (95% CI: 0.87-0.97) for statin users, and the HRs were linearly shaped (both P nonlinearity > 0.40). Compared with the nonstatin cohort, there was an increased risk of type 2 diabetes in statin users with the lowest and moderate CRF categories, but this was not present in the highest CRF category. The HR of type 2 diabetes for overweight/obesity-fit category versus normal weight-fit category was larger than that of the normal weight-unfit category versus the normal weight-fit category (P interaction = 0.004).Conclusions: There was an inverse and dose-dependent association between CRF and type 2 diabetes risk. High CRF may eliminate the diabetogenic effect from statins, yet decreased body weight index seems superior in preventing type 2 diabetes.

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Section: Discussionsupporting

confidence: 55%

Section: Introductionmentioning

confidence: 99%

Association Between Cardiorespiratory Fitness and Risk of Type 2 Diabetes: A Meta‐Analysis

Qiu

Cai

Yang

et al. 2019

Obesity

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show abstract

“…However, the primary analysis was adjusted for both age and sex, and interaction analysis in both the present study and the Rotterdam Study showed that age and sex were not important effect modifiers [17]. Additionally, compared to the Korean study, the participants in the present study used more lipid lowering medication, independently a risk factor for incident T2DM (data not available for the Rotterdam Study) [32]. However, adjustments for lipid lowering medication in an exploratory analysis in the present study had no significant effect on the risk estimate.…”

Section: Discussionmentioning

confidence: 87%

Thyroid-stimulating hormone levels in the normal range and incident type 2 diabetes mellitus

et al. 2018

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AimTo evaluate the relationship between thyroid-stimulating hormone (TSH) levels within the normal range and the risk of type 2 diabetes mellitus (T2DM) in a cohort of patients at high cardiovascular risk, and to perform a systematic review and meta-analysis of previous studies.MethodsWe included 5542 patients without T2DM from the prospective Secondary Manifestations of ARTerial disease study with TSH levels between 0.35 and 5.0 mIU/L without anti-thyroid medication or thyroid-hormone replacement therapy. Cox regression was used to investigate the relationship between baseline plasma TSH levels and incident T2DM. MEDLINE, EMBASE, and Cochrane were searched for prospective cohorts assessing TSH and incident T2DM. Hazard ratios (HR) from included prospective cohort studies were pooled using a random-effects model.ResultsIn patients at high cardiovascular risk, higher plasma TSH levels in the normal range were not associated [HR 1.07 per mIU/L increase in TSH (95% confidence interval (95% CI) 0.95–1.22)] with an increased risk of T2DM, adjusted for age, sex, smoking, total and HDL cholesterol, and triglycerides. In the meta-analysis involving three prospective cohort studies, including the present study, including 29,791 participants with 1930 incident events, there was no relation between plasma TSH levels in the normal range and incident T2DM [pooled HR 1.06 (95% CI 0.99–1.14)].ConclusionThere is no apparent relation between plasma TSH levels in the normal range and incident T2DM in patients at high cardiovascular risk.Electronic supplementary materialThe online version of this article (10.1007/s00592-018-1231-y) contains supplementary material, which is available to authorized users.

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“…We should also acknowledge that, paradoxically, certain anti-inflammatory medications, e.g. statins, used in HF could contribute to the excess risk associated with new-onset DM [47,48]. Nevertheless, this evidence has to be weighed together with the cardiovascular protection offered by these drugs, especially in patients with ischaemia, dyslipidaemia and vascular comorbidities.…”

Section: Discussionmentioning

confidence: 99%

Heart failure and inflammation-related biomarkers as predictors of new-onset diabetes in the general population

Suthahar

Meijers

Brouwers

et al. 2018

International Journal of Cardiology

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Statin use and risk of new-onset diabetes: A meta-analysis of observational studies

Cited by 124 publications

References 62 publications

Association Between Cardiorespiratory Fitness and Risk of Type 2 Diabetes: A Meta‐Analysis

Association Between Cardiorespiratory Fitness and Risk of Type 2 Diabetes: A Meta‐Analysis

Thyroid-stimulating hormone levels in the normal range and incident type 2 diabetes mellitus

Heart failure and inflammation-related biomarkers as predictors of new-onset diabetes in the general population

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