The effect of body mass index on fasting blood glucose and development of diabetes mellitus after initiation of extended-release niacin.
BACKGROUND
Niacin increases blood glucose, but whether the degree of increase is associated with increasing body mass index (BMI) is unknown. We evaluated the effect of extended-release niacin initiation on fasting plasma glucose (FPG) and the development of new-onset diabetes mellitus (DM) in relation to body mass index (kg/m(2)) in nondiabetic patients.


METHODS
This retrospective observational study used data from six facilities within a geographical region of the Department of Veterans Affairs (VA). Patients included were 18 years of age or older and on a stable extended-release niacin dose (minimum 100 days) of at least 250 mg/day between January, 2001, and April, 2007. Patients were excluded if they were new to the VA, on corticosteroids or insulin, if medication adherence was <80%, or if they met criteria for DM.


RESULTS
A total of 811 nondiabetic patients taking extended-release niacin initiation were studied. FPG after niacin initiation was stastically significantly correlated with increasing BMI (P < 0.001, R = 0.144 Pearson correlation coefficient). Factors independently associated with change in FPG using multiple linear regression were BMI (P = 0.043), baseline average glucose (P < 0.001), and baseline average triglycerides (P = 0.037). Of all patients started on niacin, 220 (27.1%) patients developed DM after niacin initiation. BMI, (P = 0.002) and baseline average glucose (P < 0.001) were independent predictors of the development of new-onset DM (logistic regression analysis).


CONCLUSIONS
We found an association between increasing BMI and increasing FPG and diagnosis of new-onset DM after initiation of extended-release niacin initiation. This suggests that extended-release niacin may increase FPG into the diabetic range, especially for obese patients.
Libby
Ardelle
A
Pharmacy Service, Department of Veterans Affairs, Northern California Health Care System, Martinez, California 95655, USA.
Meier
Joy
J
Lopez
Julio
J
Swislocki
Arthur L M
AL
Siegel
David
D
D000293:Adolescent; D000305:Adrenal Cortex Hormones / Q000494:pharmacology; D000328:Adult; D000368:Aged; D001786:Blood Glucose / Q000378:metabolism*; D015992:Body Mass Index; D003692:Delayed-Action Preparations; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000378:metabolism; D005260:Female; D006787:Hospitals, Veterans; D006801:Humans; D007328:Insulin / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D008954:Models, Biological; D009525:Niacin / Q000008:administration & dosage*; D012189:Retrospective Studies; D014481:United States
D000305:Adrenal Cortex Hormones; D001786:Blood Glucose; D003692:Delayed-Action Preparations; D007328:Insulin; D009525:Niacin