Abstract
BackgroundWe evaluated the effect of statin use on new-onset type 2 diabetes among individuals without atherosclerotic cardiovascular disease (ASCVD) using nationally representative South Korean claims data (2002–2013, N = 1,016,820).MethodsA total of 13,698 patients (statin users 5273, non-statin users 5273) aged 40–74 years, newly diagnosed with dyslipidemia but without any history of diabetes or ASCVD, were selected in 2005. We followed up the final sample until 2013 and evaluated the cumulative incidence of type 2 diabetes. We used extended Cox regression models to estimate the time-varying adjusted hazard ratios of statin use on new-onset type 2 diabetes. We performed further analyses based on the cumulative defined daily dose of statin received per year to evaluate the degree of risk compared to non-statin users.ResultsOver the mean follow-up period of 7.1 years, 3034 patients developed type 2 diabetes; the number of statin users exceeded that of non-users, demonstrating that statin use significantly increased the risk of new-onset type 2 diabetes. The risk of new-onset type 2 diabetes differed among statin users according to cDDD per year (adjusted HR = 1.31 [95% CI 1.18–1.46] for less than 30 cDDD per year; 1.58 [1.43–1.75] for 30–120 cDDD per year; 1.83 [1.62–2.08] for 120–180 cDDD per year; and 2.83 [2.51–3.19] for more than 180 cDDD per year). The diabetogenic effect of pitavastatin was not statistically significant, but the risk was the largest for atorvastatin. Long-term exposure (≥ 5 years) to statins was associated with a statistically significant increase in the risk of new onset type 2 diabetes in all statin subtypes explored, with the highest magnitude for simvastatin (HR = 1.916, 95% CI 1.647–2.228) followed by atorvastatin (HR = 1.830, 95% CI 1.487–2.252).ConclusionsStatin use was significantly associated with an increased risk of new-onset type 2 diabetes. We also found a dose–response relationship in terms of statin use duration and dose maintenance. Periodic screening and monitoring for incident type 2 diabetes may be warranted in long-term statin users.
Highlights
We evaluated the effect of statin use on new-onset type 2 diabetes among individuals without atherosclerotic cardiovascular disease (ASCVD) using nationally representative South Korean claims data (2002–2013, N = 1,016,820)
The risk of new-onset type 2 diabetes differed among statin users according to Cumulative defined daily dose (cDDD) per year (adjusted Hazard ratio (HR) = 1.31 [95% confidence intervals (CI) 1.18–1.46] for less than 30 cDDD per year; 1.58 [1.43–1.75] for 30–120 cDDD per year; 1.83 [1.62–2.08] for 120–180 cDDD per year; and 2.83 [2.51– 3.19] for more than 180 cDDD per year (Additional file 1: Table S5; Fig. 3)
The present study showed that long-term statin use can induce new-onset type 2 diabetes in South Korean patients with dyslipidemia, using a nationally representative real-world dataset from insurance claims
Summary
We evaluated the effect of statin use on new-onset type 2 diabetes among individuals without atherosclerotic cardiovascular disease (ASCVD) using nationally representative South Korean claims data (2002–2013, N = 1,016,820). Originally used in the treatment of dyslipidemia, are the drugs of choice to prevent atherosclerotic cardiovascular disease (ASCVD) events following the release of the American College of Cardiology/American Heart Association (ACC/AHA)’s 2018 guidelines on the management of blood cholesterol [1] There is a need for further assessment of the risks of statin use in terms of new-onset diabetes, considering the large number of patients in need of primary prevention of ASCVD and the widespread use of statins for that purpose [10]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
