Statins and New-Onset Diabetes Mellitus and Diabetic Complications: A Retrospective Cohort Study of US Healthy Adults.
BACKGROUND
Statin use is associated with increased incidence of diabetes and possibly with increased body weight and reduced exercise capacity. Data on the long-term effects of these associations in healthy adults, however, are very limited. In addition, the relationship between these effects and diabetic complications has not been adequately studied.


OBJECTIVE
To examine the association between statin use and new-onset diabetes, diabetic complications, and overweight/obesity in a cohort of healthy adults.


METHODS
This was a retrospective cohort study.


METHODS
Subjects were Tricare beneficiaries who were evaluated between October 1, 2003 and March 1, 2012. Patients were divided into statin users and nonusers.


METHODS
We excluded patients who, at baseline, had a preexisting disease indicative of cardiovascular diseases, any positive element of the Charlson comorbidity index (including diabetes mellitus), or life-limiting chronic diseases. Using 42 baseline characteristics, we generated a propensity score to match statin users and nonusers.


METHODS
Outcomes assessed included new-onset diabetes, diabetic complications, and overweight/obesity.


RESULTS
A total of 25,970 patients (3982 statin users and 21,988 nonusers) were identified as healthy adults at baseline. Of these, 3351 statins users and 3351 nonusers were propensity score-matched. Statin users had higher odds of new-onset diabetes (odds ratio [OR] 1.87; 95 % confidence interval [95 % CI] 1.67-2.01), diabetes with complications (OR 2.50; 95 % CI 1.88-3.32), and overweight/obesity (OR 1.14; 95 % CI 1.04-1.25). Secondary and sensitivity analyses demonstrated similar findings.


CONCLUSIONS
Diabetes, diabetic complications, and overweight/obesity were more commonly diagnosed among statin-users than similar nonusers in a healthy cohort of adults. This study demonstrates that short-term clinical trials might not fully describe the risk/benefit of long-term statin use for primary prevention.
Department of Medicine, VA North Texas Health System, 4500 S. Lancaster Rd #111E, Dallas, TX, USA. Ishak.mansi@va.gov.|Departments of Medicine and Clinical Sciences, University of Texas Southwestern, Dallas, TX, 75216, USA. Ishak.mansi@va.gov.
Ishak
I
Mansi
Pharmacotherapy Division, College of Pharmacy, The University of Texas at Austin, Austin, TX, USA.|Pharmacotherapy Education and Research Center, School of Medicine, University of Texas Health Science Center, San Antonio, TX, USA.
Christopher R
CR
Frei
University of Texas Health Science Center, San Antonio, TX, USA.
Chen-Pin
CP
Wang
Department of Medicine, VA North Texas Health System, 4500 S. Lancaster Rd #111E, Dallas, TX, USA.|Departments of Medicine and Clinical Sciences, University of Texas Southwestern, Dallas, TX, 75216, USA.
Eric M
EM
Mortensen
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015897:Comorbidity; D048909:Diabetes Complications / Q000139:chemically induced* / Q000453:epidemiology; D003924:Diabetes Mellitus, Type 2 / Q000139:chemically induced* / Q000453:epidemiology; D004363:Drug Utilization / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000139:chemically induced / Q000453:epidemiology; D050177:Overweight / Q000139:chemically induced / Q000453:epidemiology; D011322:Primary Prevention / Q000379:methods / Q000706:statistics & numerical data; D057216:Propensity Score; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D013781:Texas / Q000453:epidemiology
D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors
Adverse events; Diabetes; Diabetic complications; Observational study; Overweight/obesity; Primary prevention; Satins