Can Statins Increase the Risk for Diabetes?

In a large-scale analysis, researchers evaluated the ways in which stain use contributes to the risk of developing type 2 diabetes.

Statins work by inhibiting the productivity of the liver enzyme HMGCR, which in turn reduces circulating LDL-cholesterol in the blood stream.
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For the study, investigators examined the relationship between inhibited HMGCR with plasma lipid, glucose, and insulin concentrations, body weight, and incidence of type 2 diabetes in patients that had previously participated in studies of the impact of statins on stroke and heart disease.

Researchers found that over a 4-year period, participants assigned statins over the placebo, or who had higher doses of stains over those with lower doses, had a 12% greater chance of manifesting type 2 diabetes and to gain an average of 240g of excessive weight.

“The genetic findings of our study help to explain the mechanism by which statins increase weight and diabetes risk,” says co-senior author Professor Aroon Hingorani, director of the UCL Institute of Cardiovascular Science. “However, the effects of the genetic variants are orders of magnitude lower than the effects of statins.

“Commonly occurring variants in the gene encoding [HMGCR] are associated with a lower LDL-cholesterol,” explained co-lead author Dr Daniel Swerdlow of the UCL Institute of Cardiovascular Science. “[W]e found that these genetic variants were also associated with a higher weight and marginally higher type 2 diabetes risk. The effects were very much smaller than from statin treatment, but the genetic findings indicate that the weight gain and diabetes risk observed in the analysis from trials are related to the known mechanism of action of statins rather than some other unintended effect.”

The complete study is published in the September issue of The Lancet.

-Michelle Canales

References:

Swerdlow D, Preiss D, Kuchenbaecker KB, et al. HMG-coenzyme a reductase inhibition, type 2 diabetes, and bodyweight: evidence from genetic analysis and randomized trials. Lancet. 2014 August [epub ahead of print] doi: 10.1016/S0140-6736(14)61183-1.

UCL News. Modest effect of statins on diabetes risk and bodyweight related to mechanism of action. September 24, 2014.  https://www.ucl.ac.uk/news/news-articles/0914/240914-Statins-diabetes-bodyweight/. Accessed September 29, 2014.