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Anelli V, Armeni E, Paschou SA, Lambrinoudaki I. Statin use and incident type 2 diabetes mellitus in women after menopause. Maturitas 2024; 181:107914. [PMID: 38245965 DOI: 10.1016/j.maturitas.2024.107914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Revised: 01/06/2024] [Accepted: 01/09/2024] [Indexed: 01/23/2024]
Abstract
Menopause is associated with adverse cardiometabolic changes which increase the risk of new-onset type 2 diabetes (T2DM) and cardiovascular disease (CVD). Statins are widely used for primary and secondary CVD prevention, given their beneficial effects on the lipid profile and the vessel wall. On the other hand, statins increase the risk of T2DM. This association has been evaluated mainly in mixed-gender studies, without gender-specific evaluation. This narrative review evaluates the use of statins and the related risk of new-onset T2DM among postmenopausal women. Studies that incorporated a gender-specific analysis report a higher risk of new-onset T2DM in women than in men on treatment with statins. Fewer studies evaluated female-only samples; these confirm the observed association between statin use and new-onset T2DM. Factors influencing the association between statin use and T2DM include the type and dose of statin and the baseline metabolic status. Women may benefit from stratification of their metabolic risk before initiating a statin for CVD prevention.
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Affiliation(s)
- Valentina Anelli
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Eleni Armeni
- 2nd Department of Obstetrics and Gynecology, National and Kapodistrian University of Athens, Athens, Greece; Royal Free Hospital NHS Trust, Medical School, University College London, London, UK
| | - Stavroula A Paschou
- 2nd Department of Obstetrics and Gynecology, National and Kapodistrian University of Athens, Athens, Greece
| | - Irene Lambrinoudaki
- 2nd Department of Obstetrics and Gynecology, National and Kapodistrian University of Athens, Athens, Greece.
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Singh H, Sikarwar P, Khurana S, Sharma J. Assessing the Incidence of New-onset Diabetes Mellitus with Statin Use: A Systematic Review of the Systematic Reviews and Meta-analyses. TOUCHREVIEWS IN ENDOCRINOLOGY 2022; 18:96-101. [PMID: 36694884 PMCID: PMC9835812 DOI: 10.17925/ee.2022.18.2.96] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Accepted: 11/02/2022] [Indexed: 12/12/2022]
Abstract
Statin use has been linked with new-onset diabetes mellitus (NODM). In the present systematic review, we aimed to determine the incidence of NODM with statin use by assessing and summarizing the data generated by different systematic reviews and metaanalyses published on this topic. We conducted a systematic review of systematic reviews and meta-analyses using a pre-defined study protocol. Two authors independently performed a literature search using PubMed, Embase and the Cochrane Central Register of Controlled Trials (CENTRAL) for studies reporting data on statin use and NODM incidence and screened and extracted data for the outcomes of interest. The Assessing the Methodological Auality of Systematic Reviews 2 (AMSTAR 2) checklist was used to evaluate the quality of the included systematic reviews and meta-analyses. The initial search yielded 621 potential records, and 16 relevant systematic reviews and meta-analyses were included in the present systematic review. The included studies showed an increase in the risk of NODM with statin use. In particular, rosuvastatin and atorvastatin were associated with NODM in many systematic reviews or meta-analyses; however, pravastatin and pitavastatin were found to be associated with lower or no risk. We observed a positive trend of development of NODM with statin use became more evident with advancing years as more number of studies were added. Intensive doses of statins and use in older subjects were found to be important risk factors for NODM. Finally, the quality assessment revealed that the included systematic reviews and metaanalyses were of critically low or low quality. We concluded that statin use carries a risk of causing NODM. Statins should not be discouraged in anticipation of NODM. However, glycaemic monitoring should be encouraged with the on-going statin therapy. Furthermore, clinical studies addressing the use of statins and the incidence of NODM as their primary objective should be planned.
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Affiliation(s)
- Harmanjit Singh
- These authors have contributed equally to this work and share first authorship.,Department of Pharmacology, Government Medical College and Hospital, Chandigarh, India
| | - Pallavi Sikarwar
- These authors have contributed equally to this work and share first authorship.,MBBS Student, Government Medical College and Hospital, Chandigarh, India
| | - Supreet Khurana
- Department of Neonatology, Government Medical College and Hospital, Chandigarh, India
| | - Jatin Sharma
- Department of Pharmacology, All India Institute of Medical Sciences, New Delhi, India
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Khoury M, Bigras JL, Cummings EA, Harris KC, Hegele RA, Henderson M, Morrison KM, St-Pierre J, Wong PD, McCrindle BW. The Detection, Evaluation, and Management of Dyslipidemia in Children and Adolescents: A Canadian Cardiovascular Society/Canadian Pediatric Cardiology Association Clinical Practice Update. Can J Cardiol 2022; 38:1168-1179. [PMID: 35961755 DOI: 10.1016/j.cjca.2022.05.002] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Revised: 05/02/2022] [Accepted: 05/05/2022] [Indexed: 12/20/2022] Open
Abstract
Atherosclerosis begins in youth and is directly linked with the presence and severity of cardiovascular risk factors, including dyslipidemia. Thus, the timely identification and management of dyslipidemia in childhood might slow atherosclerotic progression and decrease the risk of cardiovascular disease in adulthood. This is particularly true for children with genetic disorders resulting in marked dyslipidemia, including familial hypercholesterolemia, which remains frequently undiagnosed. Universal and cascade screening strategies can effectively identify cases of pediatric dyslipidemia. In the clinical evaluation of children with dyslipidemia, evaluating for secondary causes of dyslipidemia, including medications and systemic disorders is essential. The first line therapy generally centres around lifestyle modifications, with dietary changes specific to the dyslipidemia phenotype. Indications for medication depend on the severity of dyslipidemia and an individualized assessment of cardiovascular risk. Despite an expanding evidence base supporting the detection and timely management of pediatric dyslipidemia, numerous knowledge gaps remain, including a sufficient evidence base to support more widespread screening, thresholds for initiation of pharmacotherapy, and treatment targets. Further studies on the most appropriate age for statin initiation and long-term safety studies of statin use in youth are also required. The most pressing matter, however, is the development of knowledge translation strategies to improve the screening and detection of lipid disorders in Canadian youth.
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Affiliation(s)
- Michael Khoury
- Division of Pediatric Cardiology, Department of Pediatrics Stollery Children's Hospital, University of Alberta, Edmonton, Alberta, Canada.
| | - Jean-Luc Bigras
- Division of Pediatric Cardiology, Department of Pediatrics, University of Montreal, Montreal, Quebec, Canada
| | - Elizabeth A Cummings
- Division of Pediatric Endocrinology, Department of Pediatrics, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Kevin C Harris
- Children's Heart Centre, BC Children's Hospital and University of British Columbia, Vancouver, British Columbia, Canada
| | - Robert A Hegele
- Department of Medicine, Schulich School of Medicine and Dentistry, London, Ontario, Canada
| | - Mélanie Henderson
- Department of Pediatrics, Université de Montréal, Montreal, Quebec, Canada; Centre de Recherche CHU Sainte-Justine, Montreal, Quebec, Canada; School of Public Health, Department of Social and Preventive Medicine, Université de Montréal, Montreal, Quebec, Canada
| | - Katherine M Morrison
- Centre for Metabolism, Obesity and Diabetes Research, Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
| | - Julie St-Pierre
- Department of Pediatrics, McGill University, Montreal, Quebec, Canada
| | - Peter D Wong
- Division of Pediatric Medicine, Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Brian W McCrindle
- Labatt Family Heart Centre, Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
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