Abstract 20856: Effects of Niacin on Glucose Levels in Patients With Normal Glucose (<100mg/dl): A Combined Analysis of the Familial Atherosclerosis Treatment Study (FATS), the HDL-Atherosclerosis Treatment Study (HATS), the Armed Forces Regression Study (AFREGS), the Carotid Plaque Composition by MRI During Lipid-Lowering Study (CPC), and the Familial Atherosclerosis Treatment Study-Observational Study (FATS-OS)
Introduction: Effect of niacin on glucose levels in subjects with diabetes has been investigated; however, the magnitude of niacin's effect on glucose in subjects with normal glucose levels has not been established. Objective: We examined the impact of niacin on glucose levels over 3 years in subjects with normal baseline glucose defined as <100mg/dl.
Methods: This analysis combined individual patient data from 429 subjects who participated in FATS, HATS, AFREGS, CPC and FATS-OS studies using lipid therapies with or without niacin and who had glucose <100 mg/dl at baseline. The mean age was 59.0±8.9 years, BMI was 27.4±4.0, 90.5% were male. Of 429, 219 received treatment with niacin and 210 without. Three types of niacin (immediate-, slow- and extended-release) and multiple dosages from 1000-6000 mg were used in these studies. Per study protocol, glucose was measured at multiple time points during 3 years after treatment initiation. Glucose levels at baseline and in study, and frequencies of new onset impaired fasting glucose (IFG) defined as glucose 100-125 mg/dl at ≥2 measurements during treatment and diabetes (DM) were compared between the subjects treated with and without niacin.
Results: Fasting glucose levels increased significantly over 3 years in both subjects treated with niacin (from 86±9 mg/dl to 95±19, p<0.001) and without niacin (from 85±10 mg/dl to 89±18, p=0.009). Subjects treated with niacin had significantly larger glucose increase than those without (11 vs. 5%, p<0.001). The glucose increase did not seem to be associated with type or dosage of niacin used. Overall, 9.6% (41/429) of subjects developed IFG over 3 years. IFG was significantly more likely to be seen in subjects treated with niacin than those without (RR=2.6, p=0.003). However, frequency of new DM did not differ significantly between the 2 groups (6.4% (14/219) vs. 4.8% (10/210), p=0.5).
Conclusions: In subjects with normal glucose, fasting glucose levels increase significantly with aging. Use of niacin adds additional glucose raise and is associated with 2.6-fold increase in risk for developing IFG, but not diabetes over 3 years. Given the increased use of niacin for raising HDL-C and lowering triglycerides, it is important to monitor and control glucose levels during niacin therapy.
- © 2010 by American Heart Association, Inc.