title: Glycaemic Effects of Non-statin Lipid-Lowering Therapies.
abstract: Since the publication of the JUPITER trial, attention has been focused on the adverse glycemic effects of statin therapy. Although the modest increase in the risk of new diabetes mellitus is outweighed by the reduction in cardiovascular events for statins, emerging biochemical and genetic links between lipid metabolism and glycemic control raise the prospect of a broader diabetogenic effect of lipid-lowering therapies. For the novel and powerful PCSK9-inhibitor class available evidence does not support a major glycaemic effect with the results of large scale trials awaited although preliminary genetic data does suggest a link. In contrast, there is clear evidence of a diabetogenic effect for the now outdated but well-studied niacin. For ezetimibe and fibrates, evidence is scarce but currently broadly unconcerning. For now, the glycemic effects of lipid-lowering therapies should have a limited influence on clinical decision-making. Further study in this topical area is needed.
authors.affiliation: University Hospital Lewisham, Lewisham High Street, London, SE13 6LH, UK.
authors.forename: Patrick D
authors.initials: PD
authors.lastname: Collins
authors.affiliation: Institute of Cardiovascular & Medical Sciences, BHF Glasgow Cardiovascular Research Centre, University Of Glasgow, 126 University Place, Glasgow, G12 8TA, UK. naveed.sattar@glasgow.ac.uk.
authors.forename: Naveed
authors.initials: N
authors.lastname: Sattar
mesh_terms: D000924:Anticholesteremic Agents / Q000627:therapeutic use; D001786:Blood Glucose / Q000378:metabolism*; D002318:Cardiovascular Diseases / Q000517:prevention & control; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000188:drug therapy* / Q000503:physiopathology; D003925:Diabetic Angiopathies / Q000097:blood / Q000188:drug therapy* / Q000503:physiopathology; D000069438:Ezetimibe / Q000627:therapeutic use; D058607:Fibric Acids / Q000627:therapeutic use; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000009:adverse effects / Q000627:therapeutic use; D006937:Hypercholesterolemia / Q000097:blood / Q000188:drug therapy* / Q000503:physiopathology; D000960:Hypolipidemic Agents / Q000009:adverse effects* / Q000627:therapeutic use*; D050356:Lipid Metabolism / Q000187:drug effects; D015201:Meta-Analysis as Topic; D009525:Niacin / Q000627:therapeutic use; D000091362:PCSK9 Inhibitors; D016032:Randomized Controlled Trials as Topic; D016896:Treatment Outcome; D000071449:Proprotein Convertase 9
chemical_list: D000924:Anticholesteremic Agents; D001786:Blood Glucose; D000069438:Ezetimibe; D058607:Fibric Acids; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D000960:Hypolipidemic Agents; D009525:Niacin; D000091362:PCSK9 Inhibitors; C472125:PCSK9 protein, human; D000071449:Proprotein Convertase 9
keywords: Diabetes; Ezetimibe; Hypercholesterolaemia; Niacin; PCSK9; Statins