While statin therapy is known to reduce cardiovascular disease, the purpose of this meta-analysis is to examine its relationship with the development of diabetes. Six cohort (WOSCOPS, HPS, LIPID, ASCOT, JUPITER, CORONA) were considered including 57 593 patients with a mean follow-up of 3.9 years during which 2 082 incident cases of type 2 diabetes were recorded. Results including 5 out of the 6 trials available demonstrated no evidence of a protective role of statin treatment on type 2 diabetes development but rather observed a small but significant increase in diabetes risk with no evidence of heterogeneity across trials. However, this effect was attenuated and no longer significant when the WOSCOPS cohort was included which also resulted in significant heterogeneity. Thus, the effect of statin therapy on type 2 diabetes development remains unknown and future statin trials should address this issue. In an accompanying editorial, Belalcazar LM et al. emphasized the protective effects of statins and the relevance of their use to prevent cardiovascular disease and subsequent death. Thus, they proposed that statin use was relevant in clinical practice despite a potential risk of new-onset diabetes. We also know little about the microvascular benefits of statin therapy. Further randomized trials are needed to better understand the risk of a moderate increase in glycemia under a background of aggressive statin therapy.
Documentation centre