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Statins and risk for new-onset diabetes mellitus: A real-world cohort study using a clinical research database

Authors
Yoon, D  | Sheen, SS  | Lee, S | Choi, YJ  | Park, RW  | Lim, HS
Citation
Medicine, 95(46). : e5429-e5429, 2016
Journal Title
Medicine
ISSN
0025-79741536-5964
Abstract
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.
MeSH

DOI
10.1097/MD.0000000000005429
PMID
27861386
Appears in Collections:
Journal Papers > School of Medicine / Graduate School of Medicine > Biomedical Informatics
Journal Papers > School of Medicine / Graduate School of Medicine > Pulmonary & Critical Care Medicine
Journal Papers > School of Medicine / Graduate School of Medicine > Endocrinology & Metabolism
Journal Papers > School of Medicine / Graduate School of Medicine > Cardiology
Ajou Authors
박, 래웅  |  신, 승수  |  윤, 덕용  |  임, 홍석  |  최, 용준
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