Cargando…

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

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....

Descripción completa

Detalles Bibliográficos
Autores principales: Yoon, Dukyong, Sheen, Seung Soo, Lee, Sukhyang, Choi, Yong Jun, Park, Rae Woong, Lim, Hong-Seok
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer Health 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5120943/
https://www.ncbi.nlm.nih.gov/pubmed/27861386
http://dx.doi.org/10.1097/MD.0000000000005429
_version_ 1782469329574428672
author Yoon, Dukyong
Sheen, Seung Soo
Lee, Sukhyang
Choi, Yong Jun
Park, Rae Woong
Lim, Hong-Seok
author_facet Yoon, Dukyong
Sheen, Seung Soo
Lee, Sukhyang
Choi, Yong Jun
Park, Rae Woong
Lim, Hong-Seok
author_sort Yoon, Dukyong
collection PubMed
description 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.
format Online
Article
Text
id pubmed-5120943
institution National Center for Biotechnology Information
language English
publishDate 2016
publisher Wolters Kluwer Health
record_format MEDLINE/PubMed
spelling pubmed-51209432016-11-28 Statins and risk for new-onset diabetes mellitus: A real-world cohort study using a clinical research database Yoon, Dukyong Sheen, Seung Soo Lee, Sukhyang Choi, Yong Jun Park, Rae Woong Lim, Hong-Seok Medicine (Baltimore) 3400 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. Wolters Kluwer Health 2016-11-18 /pmc/articles/PMC5120943/ /pubmed/27861386 http://dx.doi.org/10.1097/MD.0000000000005429 Text en Copyright © 2016 the Author(s). Published by Wolters Kluwer Health, Inc. All rights reserved. http://creativecommons.org/licenses/by-nc-nd/4.0 This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially. http://creativecommons.org/licenses/by-nc-nd/4.0
spellingShingle 3400
Yoon, Dukyong
Sheen, Seung Soo
Lee, Sukhyang
Choi, Yong Jun
Park, Rae Woong
Lim, Hong-Seok
Statins and risk for new-onset diabetes mellitus: A real-world cohort study using a clinical research database
title Statins and risk for new-onset diabetes mellitus: A real-world cohort study using a clinical research database
title_full Statins and risk for new-onset diabetes mellitus: A real-world cohort study using a clinical research database
title_fullStr Statins and risk for new-onset diabetes mellitus: A real-world cohort study using a clinical research database
title_full_unstemmed Statins and risk for new-onset diabetes mellitus: A real-world cohort study using a clinical research database
title_short Statins and risk for new-onset diabetes mellitus: A real-world cohort study using a clinical research database
title_sort statins and risk for new-onset diabetes mellitus: a real-world cohort study using a clinical research database
topic 3400
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5120943/
https://www.ncbi.nlm.nih.gov/pubmed/27861386
http://dx.doi.org/10.1097/MD.0000000000005429
work_keys_str_mv AT yoondukyong statinsandriskfornewonsetdiabetesmellitusarealworldcohortstudyusingaclinicalresearchdatabase
AT sheenseungsoo statinsandriskfornewonsetdiabetesmellitusarealworldcohortstudyusingaclinicalresearchdatabase
AT leesukhyang statinsandriskfornewonsetdiabetesmellitusarealworldcohortstudyusingaclinicalresearchdatabase
AT choiyongjun statinsandriskfornewonsetdiabetesmellitusarealworldcohortstudyusingaclinicalresearchdatabase
AT parkraewoong statinsandriskfornewonsetdiabetesmellitusarealworldcohortstudyusingaclinicalresearchdatabase
AT limhongseok statinsandriskfornewonsetdiabetesmellitusarealworldcohortstudyusingaclinicalresearchdatabase