Statin therapy on glycemic control in type 2 diabetic patients: A network meta-analysis

Cui, Jingkun; Zhou, Ren; Han, Shuyu; Wang, T. S.; Wang, L. Q.; Xie, Xinfang

doi:10.1111/jcpt.12690

Cited by 36 publications

(34 citation statements)

References 42 publications

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“…Some lipid-lowering medications can improve blood glucose metabolism [ 42 ]. Statins were associated with an increase in HbA1c compared with placebo in T2D patients [ 43 ]. Metformin monotherapy appreciably improved dyslipidemia in statin-naive patients with T2D [ 44 ].…”

Section: Discussionmentioning

confidence: 99%

Relationship between Lipid Profiles and Glycemic Control Among Patients with Type 2 Diabetes in Qingdao, China

Wang

Zhang

et al. 2020

IJERPH

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Glycosylated hemoglobin (HbA1c) was the best indicator of glycemic control, which did not show the dynamic relationship between glycemic control and lipid profiles. In order to guide the health management of Type 2 diabetes (T2D), we assessed the levels of lipid profiles and fasting plasma glucose (FPG) and displayed the relationship between FPG control and lipid profiles. We conducted a cross-sectional study that included 5822 participants. Descriptive statistics were conducted according to gender and glycemic status respectively. Comparisons for the control of lipid profiles were conducted according to glycemic control. Four logistic regression models were generated to analyze the relationship between lipid profiles and glycemic control according to different confounding factors. The metabolic control percentage of FPG, triglyceride (TG), total cholesterol (TC), high density lipoprotein cholesterol (HDL-C) and low density lipoprotein cholesterol (LDL-C) was 27.50%, 73.10%, 28.10%, 64.20% and 44.80% respectively. In the fourth model with the most confounding factors, the odds ratios (ORs) and 95% confidence intervals (CIs) of TG, TC, LDL-C and HDL-C were 0.989 (0.935, 1.046), 0.862 (0.823, 0.903), 0.987 (0.920, 1.060) and 2.173 (1.761, 2.683). TC and HDL-C were statistically significant, and TG and LDL-C were not statistically significant with adjustment for different confounding factors. In conclusion, FPG was significantly associated with HDL and TC and was not associated with LDL and TG. Our findings suggested that TC and HDL should be focused on in the process of T2D health management.

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Section: Discussionmentioning

confidence: 99%

Relationship between Lipid Profiles and Glycemic Control Among Patients with Type 2 Diabetes in Qingdao, China

Wang

Zhang

et al. 2020

IJERPH

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“…Whereas older reports warned against a possible increase in the incidence of solid malignancy, more recent meta‐analyses completely ruled out this correlation, which is also devoid of any biological plausibility considering the molecular mechanism of the action of statins . Recently, attention has focused on a higher incidence of type 2 diabetes mellitus . However, the benefits of statins largely outweigh the possible risks associated with the onset of diabetes, and this might hold true, particularly for older adults, considering the relatively limited lifespan.…”

Section: Clinical Experimental Evidence With Cholesterol‐lowering Agementioning

confidence: 99%

“…67 Recently, attention has focused on a higher incidence of type 2 diabetes mellitus. 68 However, the benefits of statins largely outweigh the possible risks associated with the onset of diabetes, and this might hold true, particularly for older adults, considering the relatively limited lifespan.…”

Section: Safety Issuesmentioning

confidence: 99%

Management of high cholesterol levels in older people

Bertolotti

Lancellotti

Mussi

2019

Geriatrics Gerontology Int

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The management of hypercholesterolemia in older adults still represents a challenge in clinical medicine. The pathophysiological alterations of cholesterol metabolism associated with aging are still incompletely understood, even if epidemiological evidence suggests that serum cholesterol levels increase with ongoing age, possibly with a plateau after the age of 80 years. Age is also one of the main determinants of cardiovascular disease, according to all cardiovascular risk estimate tools. Cholesterol‐lowering treatment, therefore, would be expected to bring significant protection, even in these patients. Unfortunately, direct experimental evidence is extremely limited, particularly in the very old age strata of the population; a clinical benefit still seems to be present, but the risk for drug‐related adverse events is clearly higher. At any rate, at the present time, definite guidelines for the correct management of hypercholesterolemia in older patients are not available. Therefore, the decision whether or not a pharmacological treatment should be set up, and the choice of the drug, need to be tailored to the individual patient, and requires accurate clinical judgment. The specific aspects of frailty and disability, along with the actual age of the patients, have to be considered together, with a comprehensive assessment approach. The present review summarizes the evidence regarding the modifications of cholesterol metabolism in older patients, the impact of lipid‐lowering drugs on cardiovascular outcomes and focuses on the considerations that can help to define the most appropriate treatment strategy, in view of the individual functional profile. Geriatr Gerontol Int 2019; 19: 375–383.

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“…The observed association between the use of statins only in 2015 with the development of pre-DM and DM indicates that glycemic changes should be detected early in these individuals, especially for a potentially reversible pre-DM condition [21]. As the possible hyperglycemic actions of statins are related to the dose and potency of the drug [22], it is understandable that the association observed among individuals who did not use statins at the end of the follow-up period (2015) was weaker. Among the individuals who used statins during the entire period, however, the non-statistically significant observed association may be due to the low statistical power, since the individuals included in this group are very small (n= 31).…”

Section: Discussionmentioning

confidence: 99%

Use of statins and the risk of developing pre-diabetes and diabetes: a longitudinal study in individuals aged 40 years or older

Curiaki¹,

González²,

Cabrera³

et al. 2020

Rev. Colomb. Cienc. Quím. Farm.

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Background: Statins are the main therapeutic option for the control of dyslipidemias and cardiovascular prevention. However, studies indicate the possibility of the use of statins cause increases in blood glucose levels. Aim: The aim of the study was to analyze the use of statin and the risk of developing pre-diabetes (DM) or DM. Methods: This was a cohort study conducted with individuals aged 40 years or older, living in a medium-sized municipality in the north of Paraná, Brazil. Data were obtained through individual interviews and laboratory tests in the years 2011 (baseline) and 2015 (follow-up). Dependent variables were the development of DM (yes; no) and the development of pre-DM or DM (yes; no). The independent variable was the use of statins (no use; use only in 2011; use only in 2015; use in 2011 and 2015). Poisson (loglinear) regression analysis was used to calculate the relative risk (RR) and 95% confidence intervals (95% CI) in generalized linear models. Results: An association was observed between the use of statins and the incidence of DM (RR 2.89, 95% CI: 1.59-5.24) and the incidence of pre-DM or DM (RR 2.01, 95% CI: 1.39-2.92) for the group of individuals who used statins only in 2015. Conclusions: The present study identified an association between the use of statins and the incidence of pre-DM and DM only for those who used them exclusively in 2015.

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Statin therapy on glycemic control in type 2 diabetic patients: A network meta-analysis

Abstract: Statins were associated with an increase in HbA1c compared with placebo. In patients with T2DM, moderate-intensity pitavastatin improved the glycemic control whereas high-intensity atorvastatin worsened it. Appropriate statins should be administered for patients with diabetes mellitus.

Cited by 36 publications

References 42 publications

Relationship between Lipid Profiles and Glycemic Control Among Patients with Type 2 Diabetes in Qingdao, China

Relationship between Lipid Profiles and Glycemic Control Among Patients with Type 2 Diabetes in Qingdao, China

Management of high cholesterol levels in older people

Use of statins and the risk of developing pre-diabetes and diabetes: a longitudinal study in individuals aged 40 years or older

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