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2016 ; 95
(46
): e5429
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Statins and risk for new-onset diabetes mellitus: A real-world cohort study using
a clinical research database
#MMPMID27861386
Yoon D
; Sheen SS
; Lee S
; Choi YJ
; Park RW
; Lim HS
Medicine (Baltimore)
2016[Nov]; 95
(46
): e5429
PMID27861386
show ga
Although concern regarding the increased risk for new-onset diabetes mellitus
(NODM) after statin treatment has been raised, there has been a lack of evidence
in real-world clinical practice, particularly in East Asians. We investigated
whether statin use is associated with risk for NODM in Koreans. We conducted a
retrospective cohort study using the clinical research database from electronic
health records. The study cohort consisted of 8265 statin-exposed and 33,060
matched nonexposed patients between January 1996 and August 2013. Matching at a
1:4 ratio was performed using a propensity score based on age, gender, baseline
glucose levels (mg/dL), and hypertension. The comparative risks for NODM with
various statins (atorvastatin, fluvastatin, pitavastatin, pravastatin,
rosuvastatin, and simvastatin) were estimated by both statin exposure versus
matched nonexposed and within-class comparisons. The incidence of NODM among the
statin-exposed group (6.000 per 1000 patient-years [PY]) was higher than that of
the nonexposed group (3.244 per 1000 PY). The hazard ratio (HR) of NODM after
statin exposure was 1.872 (95% confidence interval [CI], 1.432-2.445). Male
gender (HR, 1.944; 95% CI, 1.497-2.523), baseline glucose per mg/dL (HR, 1.014;
95% CI, 1.013-1.016), hypertension (HR, 2.232; 95% CI, 1.515-3.288), and thiazide
use (HR, 1.337; 95% CI, 1.081-1.655) showed an increased risk for NODM, while
angiotensin-converting enzyme inhibitor or angiotensin II receptor blocker showed
a decreased risk (HR, 0.774; 95% CI, 0.668-0.897). Atorvastatin-exposed patients
showed a higher risk for NODM than their matched nonexposed counterparts (HR,
1.939; 95% CI, 1.278-2.943). However, the risk for NODM was not significantly
different among statins in within-class comparisons. In conclusion, an increased
risk for NODM was observed among statin users in a practical healthcare setting
in Korea.
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