Statin use and risk of diabetes mellitus in postmenopausal women in the Women's Health Initiative.
BACKGROUND
This study investigates whether the incidence of new-onset diabetes mellitus (DM) is associated with statin use among postmenopausal women participating in the Women's Health Initiative (WHI).


METHODS
The WHI recruited 161,808 postmenopausal women aged 50 to 79 years at 40 clinical centers across the United States from 1993 to 1998 with ongoing follow-up. The current analysis includes data through 2005. Statin use was captured at enrollment and year 3. Incident DM status was determined annually from enrollment. Cox proportional hazards models were used to estimate the risk of DM by statin use, with adjustments for propensity score and other potential confounding factors. Subgroup analyses by race/ethnicity, obesity status, and age group were conducted to uncover effect modification.


RESULTS
This investigation included 153,840 women without DM and no missing data at baseline. At baseline, 7.04% reported taking statin medication. There were 10,242 incident cases of self-reported DM over 1,004,466 person-years of follow-up. Statin use at baseline was associated with an increased risk of DM (hazard ratio [HR], 1.71; 95% CI, 1.61-1.83). This association remained after adjusting for other potential confounders (multivariate-adjusted HR, 1.48; 95% CI, 1.38-1.59) and was observed for all types of statin medications. Subset analyses evaluating the association of self-reported DM with longitudinal measures of statin use in 125,575 women confirmed these findings.


CONCLUSIONS
Statin medication use in postmenopausal women is associated with an increased risk for DM. This may be a medication class effect. Further study by statin type and dose may reveal varying risk levels for new-onset DM in this population.
Rochester Methodist Hospital, MayoClinic, Rochester, MN, USA.
Annie L
AL
Culver
Ira S
IS
Ockene
Raji
R
Balasubramanian
Barbara C
BC
Olendzki
Deidre M
DM
Sepavich
Jean
J
Wactawski-Wende
Joann E
JE
Manson
Yongxia
Y
Qiao
Simin
S
Liu
Philip A
PA
Merriam
Catherine
C
Rahilly-Tierny
Fridtjof
F
Thomas
Jeffrey S
JS
Berger
Judith K
JK
Ockene
J David
JD
Curb
Yunsheng
Y
Ma
D000368:Aged; D002318:Cardiovascular Diseases / Q000188:drug therapy / Q000453:epidemiology; D003920:Diabetes Mellitus / Q000139:chemically induced* / Q000453:epidemiology*; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000009:adverse effects*; D008875:Middle Aged; D017698:Postmenopause; D057216:Propensity Score; D016016:Proportional Hazards Models; D044469:Racial Groups / Q000706:statistics & numerical data; D018570:Risk Assessment; D014481:United States / Q000453:epidemiology
D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors