1. Statins and risk for new-onset diabetes mellitus: A real-world cohort study using a clinical research database
- Author
-
Sukhyang Lee, Dukyong Yoon, Hong-Seok Lim, Seung Soo Sheen, Rae Woong Park, and Yong Jun Choi
- Subjects
Adult ,Blood Glucose ,Male ,Statin ,medicine.drug_class ,East Asians ,Observational Study ,030204 cardiovascular system & hematology ,computer.software_genre ,03 medical and health sciences ,0302 clinical medicine ,Risk Factors ,Republic of Korea ,Diabetes Mellitus ,Medicine ,Electronic Health Records ,Humans ,Rosuvastatin ,030212 general & internal medicine ,Aged ,Dyslipidemias ,Retrospective Studies ,Database ,business.industry ,Hazard ratio ,Age Factors ,statin ,nutritional and metabolic diseases ,Retrospective cohort study ,General Medicine ,electronic health record ,Middle Aged ,new-onset diabetes mellitus ,Research Design ,Cohort ,Hypertension ,ComputingMethodologies_DOCUMENTANDTEXTPROCESSING ,Female ,Hydroxymethylglutaryl-CoA Reductase Inhibitors ,business ,computer ,Pravastatin ,medicine.drug ,Fluvastatin ,Cohort study ,Research Article - Abstract
Supplemental Digital Content is available in the text, 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.
- Published
- 2016