title: Statin Use, Diabetes Incidence and Overall Mortality in Normoglycemic and Impaired Fasting Glucose Patients.
abstract: BACKGROUND
  The association between the use of statins and the risk of diabetes and increased mortality within the same population has been a source of controversy, and may underestimate the value of statins for patients at risk.
  
  
  OBJECTIVE
  We aimed to assess whether statin use increases the risk of developing diabetes or affects overall mortality among normoglycemic patients and patients with impaired fasting glucose (IFG).
  
  
  METHODS
  Observational cohort study of 13,508 normoglycemic patients (n = 4460; 33% taking statins) and 4563 IFG patients (n = 1865; 41% taking statin) among residents of Olmsted County, Minnesota, with clinical data in the Mayo Clinic electronic medical record and at least one outpatient fasting glucose test between 1999 and 2004. Demographics, vital signs, tobacco use, laboratory results, medications and comorbidities were obtained by electronic search for the period 1999-2004. Results were analyzed by Cox proportional hazards models, and the risk of incident diabetes and mortality were analyzed by survival curves using the Kaplan-Meier method.
  
  
  METHODS
  The main endpoints were new clinical diagnosis of diabetes mellitus and total mortality.
  
  
  RESULTS
  After a mean of 6 years of follow-up, statin use was found to be associated with an increased risk of incident diabetes in the normoglycemic (HR 1.19; 95% CI, 1.05 to 1.35; p = 0.007) and IFG groups (HR 1.24; 95%CI, 1.11 to 1.38; p = 0.0001). At the same time, overall mortality decreased in both normoglycemic (HR 0.70; 95% CI, 0.66 to 0.80; p < 0.0001) and IFG patients (HR 0.77, 95% CI, 0.64 to 0.91; p = 0.0029) with statin use.
  
  
  CONCLUSIONS
  In general, recommendations for statin use should not be affected by concerns over an increased risk of developing diabetes, since the benefit of reduced mortality clearly outweighs this small (19-24%) risk.
authors: Department of Medicine, Division of Endocrinology, Mayo Clinic, Rochester, MN, USA.
authors: M Regina
authors: MR
authors: Castro
authors: Institute for Health Informatics, University of Minnesota, Minneapolis, MN, USA.
authors: Gyorgy
authors: G
authors: Simon
authors: Department of Health Sciences Research, Division of Biomedical Statistics & Informatics, Mayo Clinic, Rochester, MN, USA.
authors: Stephen S
authors: SS
authors: Cha
authors: Department of Research, Olmsted Medical Center, Rochester, MN, USA.
authors: Barbara P
authors: BP
authors: Yawn
authors: Department of Health Sciences Research, Division of Epidemiology, Mayo Clinic, Rochester, MN, USA.
authors: L Joseph
authors: LJ
authors: Melton
authors: Department of Medicine, Division of General Internal Medicine, Mayo Clinic, Rochester, MN, USA. caraballo.pedro@mayo.edu.|Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA. caraballo.pedro@mayo.edu.
authors: Pedro J
authors: PJ
authors: Caraballo
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001786:Blood Glucose / Q000378:metabolism*; D016208:Databases, Factual; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000139:chemically induced* / Q000453:epidemiology; D004363:Drug Utilization / Q000706:statistics & numerical data; D005215:Fasting / Q000097:blood; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000008:administration & dosage / Q000009:adverse effects*; D015994:Incidence; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D008910:Minnesota / Q000453:epidemiology; D009026:Mortality; D018570:Risk Assessment / Q000379:methods; D055815:Young Adult
chemical_list: D001786:Blood Glucose; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors
keywords: diabetes; impaired fasting glucose; mortality; prediabetes; statins