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Statins and New-Onset Diabetes in Cardiovascular and Kidney Disease Cohorts: A Meta-Analysis
Haroon Kamran1, Eric Kupferstein1, Navneet Sharma2
1Division of Cardiovascular Medicine, State University of New York Downstate Medical Center, Brooklyn, New York, USA.
Background:
Statins have long been prescribed for the primary and secondary prevention of cardiovascular disease (CVD) and kidney disease. Their benefits and efficacy are widely accepted in current clinical practice, but like any other therapeutic agents, they have adverse effects. One of the emerging concerns with statin therapy is the development of new-onset diabetes mellitus (NODM), a dreaded risk factor for CVD and kidney disease and widely viewed as CVD equivalent. Accumulating evidence indicates that NODM is a consequence of statin use.
Methods:
We conducted a meta-analysis of studies reporting on associations between NODM and statin use. Based on strict exclusion criteria, a total of 11 studies were selected. Their data were analyzed using Comprehensive Meta-Analysis® statistical software and reported as odds ratios (OR) with 95% confidence intervals (CI).
Results:
The cumulative fixed effect for use of statin therapy and incident NODM was an OR of 1.61 (95% CI 1.55-1.68, p < 0.001). Our results suggest that statin therapy is associated with NODM, such that there is a small but significant risk of NODM among patients receiving statin for CVD prevention therapy. However, this high-risk population also has other diabetes risk factors (such as obesity and hypertension) contributing to the development of NODM.
Conclusions:
It is imperative that patients on statin therapy be monitored carefully for NODM. However, it can be argued that the risk of statin therapy is offset by the multitude of cardiovascular and kidney-protective effects provided by such an important and highly effective therapeutic agent.
Insights
Statin use is linked to a small but significant increased risk of new-onset diabetes mellitus (NODM). Patients on statins should be monitored, but the cardiovascular benefits often outweigh this risk.
Area of Science:
- Cardiovascular Medicine
- Endocrinology
- Pharmacology
Background:
- Statins are widely used for cardiovascular disease (CVD) and kidney disease prevention.
- Concerns exist regarding statin-associated adverse effects, including new-onset diabetes mellitus (NODM).
- NODM is a significant risk factor for CVD and kidney disease.
Purpose of the Study:
- To conduct a meta-analysis evaluating the association between statin use and NODM.
- To quantify the risk of NODM in patients receiving statin therapy.
Main Methods:
- A meta-analysis of 11 selected studies was performed.
- Data were analyzed using Comprehensive Meta-Analysis® statistical software.
- Results were reported as odds ratios (OR) with 95% confidence intervals (CI).
Main Results:
- Statin therapy was associated with an increased risk of NODM (OR 1.61, 95% CI 1.55-1.68, p < 0.001).
- A small but statistically significant risk of NODM was observed in patients on statins for CVD prevention.
- Other diabetes risk factors like obesity and hypertension also contribute to NODM in this population.
Conclusions:
- Careful monitoring for NODM in patients on statin therapy is essential.
- The cardiovascular and kidney-protective benefits of statins may outweigh the risk of NODM.
- Statin therapy remains a crucial intervention for CVD prevention despite the potential for NODM.
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