title: Statins do not increase the risk of developing type 2 diabetes in familial hypercholesterolemia: The SAFEHEART study.
abstract: BACKGROUND
  Familial Hypercholesterolemia (FH) is the most common monogenic disorder that causes premature coronary artery disease (CAD). Our objective was to examine the risk of new onset type 2 diabetes mellitus (T2DM) among FH patients and unaffected relatives in relation to treatment with different statins in the SAFEHEART cohort study.
  
  
  METHODS
  This is a cross-sectional and prospective cohort study in 2558 FH and 1265 unaffected relatives with a mean follow-up of 5.9 years. Several pertinent data, such as age, gender, metabolic syndrome, lipid profile, body mass index (BMI), waist circumference, HOMA-IR, dose, duration and type of statins, were obtained and examined as predictors of incident diabetes.
  
  
  RESULTS
  The new onset diabetes was 1.7% in FH and 0.2% in non FH patients (p=0.001). In multivariate logistic regression, age (OR 1.02, CI 95%: 1.02-1.08), HOMA-IR (OR 1.17, CI 95%: 1.03-1.33), metabolic syndrome (OR 3.3, CI 95%: 1.32-8.28) and specifically plasma glucose, as a component of metabolic syndrome (OR 15.7, CI 95%: 4.70-52.53) were significant predictors of new onset T2DM in the FH group alone. In the adjusted Cox regression model in FH group, age (HR 1.03, CI 95% 1.00-1.06, p=0.031) and metabolic syndrome (HR 4.16, CI 95% 1.58-10.92, p=0.004) remained significant predictors of new onset T2DM.
  
  
  CONCLUSIONS
  Our data do not support the postulated diabetogenic effect associated with high-dose statins use in our cohort of FH patients.
authors: IMIBIC/Hospital Universitario Reina Sofía/Universidad de Córdoba, Córdoba, Spain; CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Córdoba, Spain. Electronic address: fjfuentesjimenez@gmail.com.
authors: Francisco
authors: F
authors: Fuentes
authors: IMIBIC/Hospital Universitario Reina Sofía/Universidad de Córdoba, Córdoba, Spain; CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Córdoba, Spain.
authors: Juan F
authors: JF
authors: Alcala-Diaz
authors: Lipid Disorders Clinic, Centre for Cardiovascular Medicine, Royal Perth Hospital, Australia; School of Medicine and Pharmacology, University of Western Australia, Perth, Australia.
authors: Gerald F
authors: GF
authors: Watts
authors: Fundación Hipercolesterolemia Familiar, Madrid, Spain.
authors: Rodrigo
authors: R
authors: Alonso
authors: Department of Internal Medicine, Hospital Virgen del Rocío, Sevilla, Spain.
authors: Ovidio
authors: O
authors: Muñiz
authors: Department of Internal Medicine, Hospital Abente y Lago, A Coruña, Spain.
authors: José L
authors: JL
authors: Díaz-Díaz
authors: Department of Epidemiology, Madrid Health Authority, Madrid, Spain.
authors: Nelva
authors: N
authors: Mata
authors: Hospital San Pedro de Alcantara, Caceres, Spain.
authors: Juan F
authors: JF
authors: Sanchez Muñoz-Torrero
authors: Hospital San Pedro Logroño, Spain.
authors: Ángel
authors: Á
authors: Brea
authors: Hospital General Universitario Ciudad Real, Spain.
authors: Jesús
authors: J
authors: Galiana
authors: Hospital Universitario de Bellvitge, Spain.
authors: Rosaura
authors: R
authors: Figueras
authors: Department of Endocrinology, Hospital General de León, Spain.
authors: Rocio
authors: R
authors: Aguado
authors: Department of Internal Medicine, Hospital Universitario de Elche, Spain.
authors: Mar
authors: M
authors: Piedecausa
authors: Department of Internal Medicine, Hospital de Vega Baja, Orihuela, Spain.
authors: Jose M
authors: JM
authors: Cepeda
authors: Department of Endocrinology, Hospital Universitario de Lugo, Spain.
authors: Juan I
authors: JI
authors: Vidal
authors: Laboratory Clinical Analysis, Hospital Universitario Reina Sofía, Córdoba, Spain.
authors: Fernando
authors: F
authors: Rodríguez-Cantalejo
authors: IMIBIC/Hospital Universitario Reina Sofía/Universidad de Córdoba, Córdoba, Spain; CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Córdoba, Spain.
authors: Jose
authors: J
authors: López-Miranda
authors: Fundación Hipercolesterolemia Familiar, Madrid, Spain. Electronic address: pmata@colesterolfamiliar.org.
authors: Pedro
authors: P
authors: Mata
mesh_terms: D000328:Adult; D000368:Aged; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000139:chemically induced / Q000175:diagnosis* / Q000453:epidemiology*; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000009:adverse effects / Q000627:therapeutic use*; D006938:Hyperlipoproteinemia Type II / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors
keywords: Familial hypercholesterolemia; Statins; Type 2 diabetes