Abstract 055: Statins Raise Glucose Preferentially among Men Who are Older and at Greater Metabolic Risk
Background: Several major statin trials have shown increased incident diabetes and/or modest average elevations in HbA1C (e.g. PROVE-IT, JUPITER) with statins, though average effects on glucose are small: There may be a vulnerable subset.
Hypothesis: We hypothesized that advancing age and metabolic status would condition the rise in glucose on statins.
Design: Sex-stratified randomized double-blind placebo-controlled trial of simvastatin 20mg, pravastatin 40mg or placebo for 6 months. We assessed glucose-change (from baseline to 6-months) on statins relative to placebo, as a function of age and metabolic markers (HDL30, SBP>130, triglycerides>130, glucose>100) in men (N=692).
Analysis: Regression of statin-vs-placebo on glucose change was performed for subjects without and with metabolic markers. The effect of the number of metabolic markers present on the rise in glucose due to statins was examined, as measured by the interaction term of statins x #-metabolic-markers, as a function of age. Robust standard errors were used.
Results: Statins showed little effect on glucose overall. Glucose elevation due to statins emerged in the presence of each metabolic marker (Table 1A), and increased with number of metabolic markers for both simvastatin and pravastatin in older age (Table 1B).
Conclusion: Statins increase glucose particularly among persons who are older and have greater existing metabolic load.
- © 2012 by American Heart Association, Inc.