Effects of Pitavastatin, Atorvastatin, and Rosuvastatin on the Risk of New-Onset Diabetes Mellitus: A Single-Center Cohort Study.

Wei-Ting Liu,Chin Lin,Sy-Jou Chen,Tien-Ping Tsao,Min-Chien Tsai,Wei-Shiang Lin,Cheng-Chung Cheng,Jun-Ting Liou,Shu-Meng Cheng,Chin-Sheng Lin

doi:10.3390/biomedicines8110499

Wei-Ting Liu, Chin Lin + Show 8 more

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https://doi.org/10.3390/biomedicines8110499

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Abstract

Statins constitute the mainstay treatment for atherosclerotic cardiovascular disease, which is associated with the risk of new-onset diabetes mellitus (NODM). However, the effects of individual statins on the risk of NODM remain unclear. We recruited 48,941 patients taking one of the three interested statins in a tertiary hospital between 2006 and 2018. Among them, 8337 non-diabetic patients taking moderate-intensity statins (2 mg/day pitavastatin, 10 mg/day atorvastatin, and 10 mg/day rosuvastatin) were included. The pitavastatin group had a higher probability of being NODM-free than the atorvastatin and rosuvastatin groups during the 4-year follow-up (log-rank test: p = 0.038). A subgroup analysis revealed that rosuvastatin had a significantly higher risk of NODM than pitavastatin among patients with coronary artery disease (CAD) (adjusted HR [aHR], 1.47, 95% confidence interval [CI], 1.05–2.05, p = 0.025), hypertension (aHR, 1.26, 95% CI, 1.00–1.59, p = 0.047), or chronic obstructive pulmonary disease (COPD) (aHR, 1.74, 95% CI, 1.02–2.94, p = 0.04). We concluded that compared with rosuvastatin, reduced diabetogenic effects of pitavastatin were observed among patients treated with moderate-intensity statin who had hypertension, COPD, or CAD. Additional studies are required to prove the effects of different statins on the risk of NODM.

Highlights

Statins, known as 3-hydroxy-3-methylglutaryl-coenzyme A reductase inhibitors, constitute the mainstay pharmacologic treatment for dyslipidemia to prevent atherosclerotic cardiovascular diseaseBiomedicines 2020, 8, 499; doi:10.3390/biomedicines8110499 www.mdpi.com/journal/biomedicines (ASCVD) [1,2]
We investigated the effects of commonly used moderate-intensity statins on the risk of new-onset diabetes mellitus (NODM) by utilizing a single-institute real-world database from 2006 to 2018, containing more than 48,000 patients
The pitavastatin group had a higher proportion of patients with coronary artery disease (CAD) (42%) and hypertension (60.7%) compared with the atorvastatin and rosuvastatin groups (p < 0.001 for CAD and hypertension)

Summary

Introduction

Known as 3-hydroxy-3-methylglutaryl-coenzyme A reductase inhibitors, constitute the mainstay pharmacologic treatment for dyslipidemia to prevent atherosclerotic cardiovascular diseaseBiomedicines 2020, 8, 499; doi:10.3390/biomedicines8110499 www.mdpi.com/journal/biomedicines (ASCVD) [1,2]. Current guidelines recommend targeting a lower low-density lipoprotein cholesterol (LDL-C) level for individuals with higher cardiovascular risk and intensifying statin treatment before adding ezetimibe to the treatment regimen [1,2]. Statins are effective and safe [4], several studies have raised concerns regarding the risk of new-onset diabetes mellitus (NODM) after statin therapy [5,6,7,8]. Because the therapeutic target of LDL-C is lower in current guidelines than the previous ones, clinicians should be aware of the risk of NODM associated with statin therapy. The effects of different statins on the risk of NODM are controversial. Previous studies have highlighted the class effects of statins on NODM development and glucose metabolism [9,10]

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