Statins and risk of incident diabetes: a collaborative meta-analysis of randomised statin trials
Sattar N, Preiss D, Murray HM, Welsh P, Buckley BM, de Craen AJ, Seshasai SR, McMurray JJ, Freeman DJ, Jukema JW, Macfarlane PW, Packard CJ, Stott DJ, Westendorp RG, Shepherd J, Davis BR, Pressel SL, Marchioli R, Marfisi RM, Maggioni AP, Tavazzi L, Tognoni G, Kjekshus J, Pedersen TR, Cook TJ, Gotto AM, Clearfield MB, Downs JR, Nakamura H, Ohashi Y, Mizuno K, Ray KK, Ford I
Lancet (London, England) · 1,728 citas
Etiquetas de revisión
Financiación no declaradaDatos neutrales que nuestra revisión registró sobre cómo se hizo este estudio. Describen el método, nunca si nos gusta el resultado.
Cómo se estudió
- Diseño
- Metaanálisis (indexado por PubMed)
- Estudiado en
- Personas
- Resultado principal
- Eventos clínicos como enfermedad o muerte
Quién lo pagó
- Financiación
- Financiación no declarada
Publicación
- Publicado
- 2010-02-01 · Lancet · vol. 375 · número 9716 · págs. 735–742
- Editorial
- Elsevier BV
- Citado
- 2,433 citas · más que el 100% de estudios similares · 28.8× el promedio de su campo
- Impacto
- Entre el 10 % más citado de su campo
- Referencias
- 40 trabajos
- Acceso
- De pago
- Áreas de investigación
- Lipoproteins and Cardiovascular Health · Cancer, Lipids, and Metabolism · Diabetes, Cardiovascular Risks, and Lipoproteins
- Palabras clave
- statins, new-onset diabetes, diabetes risk, statin adverse effects, LDL cholesterol lowering, cardiovascular risk, statin trials, body mass index, age as risk factor
- MeSH
- humans, cardiovascular diseases, diabetes mellitus, type 2, anticholesteremic agents, hydroxymethylglutaryl-coa reductase inhibitors, treatment outcome, risk factors, age factors, age distribution, aged, middle aged, female, male, randomized controlled trials as topic
33 autores
- Naveed A. Sattar🇬🇧British Heart Foundation; University of Glasgow
- David Preiss🇬🇧University of Glasgow
- Heather M. Murray🇬🇧University of Glasgow
- Paul I. Welsh🇬🇧University of Glasgow
- Brendan Martin Buckley🇮🇪Cork University Hospital
- Anton J.M. de Craen🇳🇱Leiden University
- Sreenivasa Rao Kondapally Seshasai🇬🇧University of Cambridge
- John J.V. McMurray🇬🇧University of Glasgow
- Dilys J. Freeman🇬🇧University of Glasgow
- J. Wouter Jukema🇳🇱Leiden University
- P. W. Macfarlane🇬🇧University of Glasgow
- Chris J. Packard🇬🇧University of Glasgow
- David J. Stott🇬🇧University of Glasgow
- Rudi G. J. Westendorp🇳🇱Netherlands Consortium for Healthy Ageing
- James Shepherd🇬🇧University of Glasgow
- Barry R. Davis
- Sara Pressel
- Roberto Marchioli
- Rosa Maria Marfisi
- Aldo Pietro Maggioni🇮🇹Associazione Nazionale Medici Cardiologi Ospedalieri
- Luigi Tavazzi
- Gianni Tognoni
- JOHN K. KJEKSHUS🇳🇴Oslo University Hospital
- Terje Rolf Pedersen🇳🇴Oslo University Hospital
- Thomas J. Cook
- Antonio M. Gotto🇺🇸Cornell University; Weill Cornell Medicine
- Michael B. Clearfield
- John R. Downs🇺🇸The University of Texas at San Antonio Health Science Center
- Haruo Nakamura🇯🇵Mitsukoshi Health and Welfare Foundation
- Yasuo Ohashi🇯🇵The University of Tokyo
- Kyoichi Mizuno🇯🇵Nippon Medical School
- Kausik Kumar Ray🇬🇧University of Cambridge
- Ian Ford🇬🇧University of Glasgow
Resumen
El texto original del estudio, en el idioma en que se publicó.
Background
Trials of statin therapy have had conflicting findings on the risk of development of diabetes mellitus in patients given statins. We aimed to establish by a meta-analysis of published and unpublished data whether any relation exists between statin use and development of diabetes.
Methods
We searched Medline, Embase, and the Cochrane Central Register of Controlled Trials from 1994 to 2009, for randomised controlled endpoint trials of statins. We included only trials with more than 1000 patients, with identical follow-up in both groups and duration of more than 1 year. We excluded trials of patients with organ transplants or who needed haemodialysis. We used the I(2) statistic to measure heterogeneity between trials and calculated risk estimates for incident diabetes with random-effect meta-analysis.
Findings
We identified 13 statin trials with 91 140 participants, of whom 4278 (2226 assigned statins and 2052 assigned control treatment) developed diabetes during a mean of 4 years. Statin therapy was associated with a 9% increased risk for incident diabetes (odds ratio [OR] 1.09; 95% CI 1.02-1.17), with little heterogeneity (I(2)=11%) between trials. Meta-regression showed that risk of development of diabetes with statins was highest in trials with older participants, but neither baseline body-mass index nor change in LDL-cholesterol concentrations accounted for residual variation in risk. Treatment of 255 (95% CI 150-852) patients with statins for 4 years resulted in one extra case of diabetes.
Interpretation
Statin therapy is associated with a slightly increased risk of development of diabetes, but the risk is low both in absolute terms and when compared with the reduction in coronary events. Clinical practice in patients with moderate or high cardiovascular risk or existing cardiovascular disease should not change.
Funding
None.
Resumen vía Europe PMC. Los derechos de autor siguen siendo de los autores o la editorial.
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