title: Statins worsen glycemic control of T2DM in target LDL-c level and LDL-c reduction dependent manners: a meta-analysis.
abstract: OBJECTIVE
  Recent studies demonstrated that a low target low-density lipoprotein cholesterol (LDL-c) level, high LDL-c reduction and high dose of statin therapy increased incident diabetes. This study aimed to explore how statin therapy influences glycemic control in type 2 diabetes mellitus (T2DM).
  
  
  METHODS
  Medline, Embase, and Cochrane Central were searched for randomized control trials inT2DM. Trials with target LDL-c levels of ≤2.6 mmol/L or LDL-c reduction of ≥30% were analyzed. Then, we calculated mean differences in glycosylated hemoglobin (HbA1c) and fasting blood glucose via stratified LDL-c level, relative LDL-c reduction and statin dose.
  
  
  RESULTS
  In total, trials involving 6,875 participants (3,619 statins, 3,256 controls) were included. Meta-analysis showed that detrimental effect of intensive LDL-c lowering statin therapy on HbA1c (SMD 0.10%; 95% CI 0.05, 0.15; p = 0.000) was more severe than all statin trials analyzed together (SMD 0.07%; 95% CI 0.02, 0.12; p = 0.005). Stratified analyses revealed that the effects on HbA1c became increasingly significant as target LDL-c level decreased and LDL-c reduction increased. Low baseline LDL-c and endpoint LDL-c levels were risk factors involved in increasing HbA1c level during statin therapy.
  
  
  CONCLUSIONS
  Statin therapy worsens the glycemic control of T2DM in target LDL-c level and LDL-c reduction dependent manners.
authors.affiliation: a Department of Endocrinology , The Affiliated ZhongDa Hospital of Southeast University , Nanjing , PR China.|b Medical School of Southeast University , Nanjing , PR China.
authors.forename: Rongrong
authors.initials: R
authors.lastname: Cai
authors.affiliation: a Department of Endocrinology , The Affiliated ZhongDa Hospital of Southeast University , Nanjing , PR China.
authors.forename: Yang
authors.initials: Y
authors.lastname: Yuan
authors.affiliation: a Department of Endocrinology , The Affiliated ZhongDa Hospital of Southeast University , Nanjing , PR China.
authors.forename: Jie
authors.initials: J
authors.lastname: Sun
authors.affiliation: a Department of Endocrinology , The Affiliated ZhongDa Hospital of Southeast University , Nanjing , PR China.
authors.forename: Wenqing
authors.initials: W
authors.lastname: Xia
authors.affiliation: a Department of Endocrinology , The Affiliated ZhongDa Hospital of Southeast University , Nanjing , PR China.
authors.forename: Rong
authors.initials: R
authors.lastname: Huang
authors.affiliation: a Department of Endocrinology , The Affiliated ZhongDa Hospital of Southeast University , Nanjing , PR China.
authors.forename: Sai
authors.initials: S
authors.lastname: Tian
authors.affiliation: a Department of Endocrinology , The Affiliated ZhongDa Hospital of Southeast University , Nanjing , PR China.
authors.forename: Xue
authors.initials: X
authors.lastname: Dong
authors.affiliation: a Department of Endocrinology , The Affiliated ZhongDa Hospital of Southeast University , Nanjing , PR China.
authors.forename: Yanjue
authors.initials: Y
authors.lastname: Shen
authors.affiliation: a Department of Endocrinology , The Affiliated ZhongDa Hospital of Southeast University , Nanjing , PR China.
authors.forename: Shaohua
authors.initials: S
authors.lastname: Wang
mesh_terms: D001786:Blood Glucose / Q000187:drug effects; D008078:Cholesterol, LDL / Q000097:blood*; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy*; D006442:Glycated Hemoglobin; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000009:adverse effects* / Q000627:therapeutic use; D016032:Randomized Controlled Trials as Topic; D012307:Risk Factors
chemical_list: D001786:Blood Glucose; D008078:Cholesterol, LDL; D006442:Glycated Hemoglobin; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors
keywords: Diabetes; HbA1c; LDL-c; meta-analysis; statins