title: Statin therapy and risk of diabetes in patients with heterozygous familial hypercholesterolemia or familial combined hyperlipidemia.
abstract: OBJECTIVE
  Controversial findings exist regarding potential influence of statin therapy on diabetic incidence. Aim of this study was to investigate the role of long duration statin treatment on diabetes mellitus (DM) incidence of Heterozygous Familial Hypercholesterolemia (hFH) and Familial Combined Hyperlipidemia (FCH) patients.
  
  
  METHODS
  Study population consisted of 212 hFH and 147 FCH patients that visited Lipid Outpatient Department (mean follow up of 11 and 10 years respectively). Several clinical data such as history of DM, cardiovascular disease, thyroid function, metabolic syndrome, glucose levels, lipid profile and lifestyle data were obtained. In order to compare the effects of different doses of different types of statins, a "statin treatment intensity product" was used.
  
  
  RESULTS
  14% of FCH and only 1% of hFH patients developed DM during follow up. Although univariate analysis showed a statistical trend (p = 0.06) in the association between new onset DM and statin treatment intensity (STI) in the FCH subgroup of patients with normal baseline glucose levels, this was no longer significant after adjusting for several confounders. Furthermore, the type of statins used did not seem to play a role in the development of DM either in hFH or FCH patients.
  
  
  CONCLUSIONS
  Long duration of high STI does not seem to be associated with diabetic risk in hFH patients. High STI used in the FCH population is not associated with increased risk of new onset DM compared to low STI. Further studies are required in order to clarify the potential diabetogenic effects of statins in these high risk populations.
authors.affiliation: First Department of Cardiology, Athens Medical School, Hippokration Hospital, 114 Vasilissis Sofias str., 115 27, Athens, Greece. Electronic address: skoumasj@gmail.com.
authors.forename: John
authors.initials: J
authors.lastname: Skoumas
authors.affiliation: First Department of Cardiology, Athens Medical School, Hippokration Hospital, 114 Vasilissis Sofias str., 115 27, Athens, Greece. Electronic address: k.liontou@gmail.com.
authors.forename: Catherine
authors.initials: C
authors.lastname: Liontou
authors.affiliation: First Department of Cardiology, Athens Medical School, Hippokration Hospital, 114 Vasilissis Sofias str., 115 27, Athens, Greece. Electronic address: chrysohoou@usa.net.
authors.forename: Christina
authors.initials: C
authors.lastname: Chrysohoou
authors.affiliation: First Department of Cardiology, Athens Medical School, Hippokration Hospital, 114 Vasilissis Sofias str., 115 27, Athens, Greece. Electronic address: kmasoura@gmail.com.
authors.forename: Constantina
authors.initials: C
authors.lastname: Masoura
authors.affiliation: First Department of Cardiology, Athens Medical School, Hippokration Hospital, 114 Vasilissis Sofias str., 115 27, Athens, Greece. Electronic address: conazna@yahoo.com.
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Aznaouridis
authors.affiliation: First Department of Cardiology, Athens Medical School, Hippokration Hospital, 114 Vasilissis Sofias str., 115 27, Athens, Greece. Electronic address: cpitsavo@med.uoa.gr.
authors.forename: Christos
authors.initials: C
authors.lastname: Pitsavos
authors.affiliation: First Department of Cardiology, Athens Medical School, Hippokration Hospital, 114 Vasilissis Sofias str., 115 27, Athens, Greece.
authors.forename: Christodoulos
authors.initials: C
authors.lastname: Stefanadis
mesh_terms: D000328:Adult; D000886:Anthropometry; D001786:Blood Glucose / Q000737:chemistry; D001794:Blood Pressure; D048909:Diabetes Complications / Q000188:drug therapy*; D003920:Diabetes Mellitus / Q000188:drug therapy; D005260:Female; D006579:Heterozygote; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000009:adverse effects* / Q000627:therapeutic use; D006950:Hyperlipidemia, Familial Combined / Q000150:complications* / Q000188:drug therapy* / Q000235:genetics; D006949:Hyperlipidemias / Q000150:complications* / Q000188:drug therapy* / Q000235:genetics; D015994:Incidence; D008019:Life Style; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012307:Risk Factors; D016896:Treatment Outcome
chemical_list: D001786:Blood Glucose; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors
keywords: Diabetes mellitus; Familial combined hyperlipidemia; Heterozygous familial hypercholesterolemia; Statins