Effect of statins on fasting plasma glucose in diabetic and nondiabetic patients.
BACKGROUND
The 3-hydroxy-3-methylglutaryl-CoA reductase inhibitors (statins) reduce serum cholesterol level and cardiovascular morbidity and mortality. However, the effect of statins on glucose metabolism is unclear. Some studies have suggested that statins may cause hyperglycemia by increasing calcium concentration in the islet cells leading to decrease in insulin release or by decreasing GLUT 4-mediated peripheral glucose uptake.


METHODS
We analyzed the data in 345,417 patients (mean age 61 +/- 15 years, 94% males, 6% diabetic, 20% statin users) from the Veterans Affairs VISN 16 database. We studied change in fasting plasma glucose (FPG) in this population over a mean time of 2 years between the first available measurement and the last measurement form the most recent recorded visit. Data were limited to patients who had 2 FPG measurements. Diagnosis of diabetes had to be present before the first FPG measurement.


RESULTS
Among patients without diabetes, FPG increased with statin use from 98 mg/dL to 105 mg/dL, and among nonstatin users, FPG increased from 97 mg/dL to 101 mg/dL (increase in FPG with statin use P < 0.0001). Among patients with diabetes, FPG increased with statin use from 102 mg/dL to 141 mg/dL, and among nonstatin users, FPG increased from 100 mg/dL to 129 mg/dL (increase in FPG with statin use; P < 0.0001). After adjustment for age and use of aspirin, beta-blockers, and angiotensin-converting enzyme inhibitors, the change in FPG in nondiabetic statin users was 7 mg/dL (vs 5 mg/dL in nonstatin users, P < 0.0001) and for diabetic statin users it was 39 mg/dL (vs 32 in nonstatin users, P < 0.0001).


CONCLUSIONS
Statin use is associated with a rise of FPG in patients with and without diabetes. This relationship between statin use and rise in FPG is independent of age and use of aspirin, beta-blockers, and angiotensin-converting enzyme inhibitors.
Sukhija
Rishi
R
Division of Cardiovascular Medicine, Central Arkansas Veterans Healthcare System and the University of Arkansas for Medical Sciences, Little Rock, AR 72205, USA.
Prayaga
Sastry
S
Marashdeh
Mohammad
M
Bursac
Zoran
Z
Kakar
Priyanka
P
Bansal
Darpan
D
Sachdeva
Rajesh
R
Kesan
Sree Hari
SH
Mehta
Jawahar L
JL
D000368:Aged; D001786:Blood Glucose / Q000187:drug effects*; D016208:Databases, Factual; D048909:Diabetes Complications / Q000097:blood / Q000188:drug therapy; D003920:Diabetes Mellitus / Q000097:blood / Q000188:drug therapy*; D050171:Dyslipidemias / Q000097:blood / Q000188:drug therapy; D005215:Fasting; D005508:Food Deprivation; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D006973:Hypertension / Q000150:complications / Q000188:drug therapy / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome; D014481:United States; D014728:Veterans
D001786:Blood Glucose; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors