Rees-Milton KJ, Norman P, Babiolakis C, Hulbert M, Turner ME, Berger C, Anastassiades TP, Hopman WM, Adams MA, Powley WL, Holden RM. Statin Use is Associated With Insulin Resistance in Participants of the Canadian Multicentre Osteoporosis Study.
J Endocr Soc 2020;
4:bvaa057. [PMID:
32715271 PMCID:
PMC7371386 DOI:
10.1210/jendso/bvaa057]
[Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Accepted: 05/08/2020] [Indexed: 12/15/2022] Open
Abstract
Context
Statins have been linked to the development of diabetes and atherosclerotic plaque calcification in patients with cardiac disease.
Objective
To determine the association between statin use and statin characteristics and insulin resistance and abdominal aortic calcification (AAC) in participants of the Canadian Multicentre Osteoporosis Study (CaMos).
Design
Observational study.
Setting
General community.
Participants
Nondiabetic participants of the Kingston CaMos site.
Intervention
Insulin resistance and AAC in statin users and nonstatin users were compared with and without the inclusion of a propensity score (PS) to be on a statin. The covariates of hypertension, sex, body mass index, smoking, kidney stones, and age that were included in the PS were selected based on clinical judgment confirmed by the statistical analysis of a difference between statin users and nonstatin users.
Main Outcome Measures
Insulin resistance measured by the homeostasis model assessment (HOMA-IR) and AAC assessed on lateral spine radiographs using the Framingham methodology.
Results
Using a general linear model, statin use was associated with higher levels of HOMA-IR after stratified PS adjustment (β = 1.52, [1.18-1.95], P < 0.01). Hydrophilic statin users (n = 9) and lipophilic statins users (n = 30) had higher HOMA-IR compared to nonstatin users (n = 125) ([β = 2.29, (1.43-3.68), P < 0.001] and [β = 1.36, (1.04-1.78), P < 0.05]), respectively, in general linear models after stratified PS adjustment. Statin use was associated with AAC without stratifying by PS in the Wilcoxon test, but was no longer significant when stratified by PS.
Conclusions
Statins, widely prescribed drugs to lower cholesterol, may have unintended consequences related to glucose homeostasis that could be relevant in healthy aging.
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