title: Effect of fitness on incident diabetes from statin use in primary prevention.
abstract: OBJECTIVE
  To assess the effect of cardiorespiratory fitness on the association between the initiation of statin therapy and incident diabetes.
  
  
  METHODS
  In a prospective observational study, we studied 6519 generally healthy men and 2334 women with two preventive health examinations from December 15, 1998 through December 18, 2013 which included measurement of fitness levels, statin therapy, risk factors for diabetes, and incident diabetes.
  
  
  RESULTS
  93 cases of incident diabetes occurred during an average follow-up of 3.0 years. After multivariable adjustment, an increased odds of incident diabetes with statin use was observed in those patients with impaired fasting glucose at baseline (odds ratio [OR]: 2.15, [95% CI:1.26 to 3.67]), but not among individuals with normal glucose levels (OR:1.85, [95% CI: 0.76 to 4.52]). Cardiorespiratory fitness attenuated but did not eliminate the increased risk of incident diabetes with statin use.
  
  
  CONCLUSIONS
  In a population of relatively healthy patients, statin use was not associated with incident diabetes in patients with normal fasting glucose at baseline. However, it was associated with incident diabetes in those patients with impaired fasting glucose at baseline, though this risk was substantially reduced by increasing fitness. In addition, increasing cardiorespiratory fitness was inversely associated with incident diabetes whether or not a patient was treated with a statin.
authors.affiliation: Cooper Clinic, Dallas, TX, USA.
authors.forename: Nina B
authors.initials: NB
authors.lastname: Radford
authors.affiliation: The Cooper Institute, Dallas, TX, USA.
authors.forename: Laura F
authors.initials: LF
authors.lastname: DeFina
authors.affiliation: The Cooper Institute, Dallas, TX, USA. Electronic address: bwright@cooperinst.org.
authors.forename: Carolyn E
authors.initials: CE
authors.lastname: Barlow
authors.affiliation: The Cooper Institute, Dallas, TX, USA.
authors.forename: Alice
authors.initials: A
authors.lastname: Kerr
authors.affiliation: Texas Health Presbyterian Hospital, Dallas, TX, USA.
authors.forename: Ripa
authors.initials: R
authors.lastname: Chakravorty
authors.affiliation: Division of Cardiology, Department of Medicine, University of Texas Southwestern Medical Center, Dallas, TX, USA.
authors.forename: Amit
authors.initials: A
authors.lastname: Khera
authors.affiliation: Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital, University of Texas Southwestern Medical Center, Dallas, TX, USA.
authors.forename: Benjamin D
authors.initials: BD
authors.lastname: Levine
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001786:Blood Glucose / Q000032:analysis; D001794:Blood Pressure; D048909:Diabetes Complications / Q000453:epidemiology; D003920:Diabetes Mellitus / Q000453:epidemiology* / Q000628:therapy*; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000009:adverse effects* / Q000627:therapeutic use; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D010809:Physical Fitness; D011322:Primary Prevention / Q000379:methods; D011446:Prospective Studies; D016032:Randomized Controlled Trials as Topic; D012307:Risk Factors; D055815:Young Adult
chemical_list: D001786:Blood Glucose; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors
keywords: Cardiorespiratory fitness; Diabetes; Statin medication