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Statins and new-onset diabetes in primary prevention setting: an updated meta-analysis stratified by baseline diabetes risk

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Abstract

Aims

The use of statins has been associated with an increased risk of new-onset diabetes. The characteristics of the population could influence this association. The objective of this study was to determine the risk of new-onset diabetes with the use of statins in patients in primary prevention, with an assessment of the results according to the baseline risk of developing diabetes of the included population.

Methods

We performed an updated meta-analysis including randomized trials of statin therapy in primary prevention settings that report new-onset diabetes. The rate of new cases of diabetes in the control arms was estimated for each study. The studies were classified into two groups (low rate: < 7.5 events per 1000 patients-year; high rate; ≥ 7.5 events per 1000 patients-year). The fixed-effects model was performed.

Results

Eight studies (70,453 patients) were included. Globally, statin therapy was associated with an increased risk of new-onset diabetes (OR 1.1; 95% CI 1.0–1.2, I2 35%). When we analyzed the studies according to the baseline diabetes risk in the control groups, the results showed that there was a greater risk only in the studies with a high baseline rate (OR 1.2; 95% CI 1.1–1.3, I2 0%; interaction p value = 0.01).

Conclusion

Globally, the use of statins in patients in primary prevention was associated with an increased risk of new-onset diabetes. In the stratified analysis, this association was observed only in the group of studies with a high baseline rate of events.

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Availability of data and material

The data underlying this article are available in the article and in its online supplementary material.

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Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

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Authors and Affiliations

  1. Cardiology Department, Hospital Italiano de Buenos Aires, Perón 4190. Ciudad Autónoma de Buenos Aires, C1199ABB, Buenos Aires, Argentina

    Walter Masson & Leandro Barbagelata

  2. Cardiology Department, Hospital Militar Campo de Mayo, Buenos Aires, Argentina

    Martín Lobo

  3. Universidad Internacional de Las Américas, San José, Costa Rica

    Juan P. Nogueira

  4. Centro de Investigación en Endocrinología, Nutrición y Metabolismo (CIENM), Universidad Nacional de Formosa, Facultad de Ciencias de La Salud, Formosa, Argentina

    Juan P. Nogueira

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  1. Walter Masson
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Contributions

WM and LB participated in the conception and design of the research. WM, LB and JPN participated in the data collection. The interpretation of the data and the statistical analysis was done by WM and ML. WM and LB drafted the manuscript. All authors performed a critical review of the final document. All authors have read and agreed to the published version of the manuscript.

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Correspondence to Walter Masson.

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This article is based on previously conducted studies and does not contain any studies with human participants or animals performed by any of the authors.

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Masson, W., Lobo, M., Barbagelata, L. et al. Statins and new-onset diabetes in primary prevention setting: an updated meta-analysis stratified by baseline diabetes risk. Acta Diabetol 61, 351–360 (2024). https://doi.org/10.1007/s00592-023-02205-w

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  • DOI: https://doi.org/10.1007/s00592-023-02205-w

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