title: Effect of change in body weight on incident diabetes mellitus in patients with stable coronary artery disease treated with atorvastatin (from the treating to new targets study).
abstract: Features of the metabolic syndrome are independent risk factors for new-onset diabetes mellitus (NODM) related to statin therapy. Obesity is the predominant underlying risk factor for the metabolic syndrome and diabetes mellitus. This study investigated whether change in body weight may predict NODM in statin-treated patients. A total of 7,595 patients without prevalent diabetes mellitus at baseline from the Treating to New Targets (TNT) study were included in this analysis. They were randomized to atorvastatin 10 or 80 mg/day and monitored for a median of 4.9 years. NODM developed in 659 patients (8.1% in the 10-mg group and 9.2% in the 80-mg group). There was a significant increase in body weight (0.9 kg, p <0.01 in both men and women) over 1 year after randomization. The increase in body weight was greater in patients with NODM than those without NODM (1.6 vs 0.9 kg, p <0.001). The association of change in body weight with NODM risk remained significant after adjusting for confounding factors (hazard ratios 1.33, 1.42, and 1.88 for quartiles 2, 3, and 4 compared with quartile 1, respectively). Similar results were obtained in patients with normal fasting glucose level. In conclusion, 1-year change in body weight is predictive of NODM in patients who underwent statin therapy from the TNT trial. Our study highlights the importance of weight control as a lifestyle measure to prevent statin-related NODM.
authors.affiliation: Centre for Vascular Research, University of New South Wales, Sydney, New South Wales, Australia; Faculty of Medicine, University of Sydney, Sydney, New South Wales, Australia.
authors.forename: Kwok-Leung
authors.initials: KL
authors.lastname: Ong
authors.affiliation: Division of Cardiology, San Francisco General Hospital and the University of California at San Francisco, San Francisco, California. Electronic address: dwaters@medsfgh.ucsf.edu.
authors.forename: David D
authors.initials: DD
authors.lastname: Waters
authors.affiliation: Pfizer, Inc., New York, New York.
authors.forename: Michael
authors.initials: M
authors.lastname: Messig
authors.affiliation: Pfizer, Inc., New York, New York.
authors.forename: David A
authors.initials: DA
authors.lastname: DeMicco
authors.affiliation: Centre for Vascular Research, University of New South Wales, Sydney, New South Wales, Australia; Faculty of Medicine, University of Sydney, Sydney, New South Wales, Australia.
authors.forename: Kerry-Anne
authors.initials: KA
authors.lastname: Rye
authors.affiliation: Centre for Vascular Research, University of New South Wales, Sydney, New South Wales, Australia; Faculty of Medicine, University of Sydney, Sydney, New South Wales, Australia.
authors.forename: Philip J
authors.initials: PJ
authors.lastname: Barter
mesh_terms: D000069059:Atorvastatin; D001835:Body Weight; D003324:Coronary Artery Disease / Q000150:complications / Q000188:drug therapy*; D003920:Diabetes Mellitus / Q000139:chemically induced / Q000453:epidemiology* / Q000517:prevention & control; D004305:Dose-Response Relationship, Drug; D005260:Female; D005500:Follow-Up Studies; D014943:Global Health; D006538:Heptanoic Acids / Q000008:administration & dosage* / Q000009:adverse effects; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000008:administration & dosage / Q000009:adverse effects; D015994:Incidence; D008019:Life Style; D008297:Male; D008875:Middle Aged; D011758:Pyrroles / Q000008:administration & dosage* / Q000009:adverse effects; D012307:Risk Factors; D013997:Time Factors; D015431:Weight Loss
chemical_list: D006538:Heptanoic Acids; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D011758:Pyrroles; D000069059:Atorvastatin