Freeman D J, Norrie J, Sattar N, Neely R D, Cobbe S M, Ford I, Isles C, Lorimer A R, Macfarlane P W, McKillop J H, Packard C J, Shepherd J, Gaw A
Department of Biological Sciences, University of Durham, Durham, UK.
Circulation. 2001 Jan 23;103(3):357-62. doi: 10.1161/01.cir.103.3.357.
We examined the development of new diabetes mellitus in men aged 45 to 64 years during the West of Scotland Coronary Prevention Study.
Our definition of diabetes mellitus was based on the American Diabetic Association threshold of a blood glucose level of >/=7.0 mmol/L. Subjects who self-reported diabetes at baseline or had a baseline glucose level of >/=7.0 mmol/L were excluded from the analyses. A total of 5974 of the 6595 randomized subjects were included in the analysis, and 139 subjects became diabetic during the study. The baseline predictors of the transition from normal glucose control to diabetes were studied. In the univariate model, body mass index, log triglyceride, log white blood cell count, systolic blood pressure, total and HDL cholesterol, glucose, and randomized treatment assignment to pravastatin were significant predictors. In a multivariate model, body mass index, log triglyceride, glucose, and pravastatin therapy were retained as predictors of diabetes in this cohort.
We concluded that the assignment to pravastatin therapy resulted in a 30% reduction (P:=0.042) in the hazard of becoming diabetic. By lowering plasma triglyceride levels, pravastatin therapy may favorably influence the development of diabetes, but other explanations, such as the anti-inflammatory properties of this drug in combination with its endothelial effects, cannot be excluded with these analyses.
在苏格兰西部冠心病预防研究中，我们研究了45至64岁男性新发糖尿病的情况。
我们对糖尿病的定义基于美国糖尿病协会血糖水平≥7.0 mmol/L的阈值。在基线时自我报告患有糖尿病或基线血糖水平≥7.0 mmol/L的受试者被排除在分析之外。6595名随机分组的受试者中共有5974名被纳入分析，139名受试者在研究期间患糖尿病。研究了从正常血糖控制转变为糖尿病的基线预测因素。在单变量模型中，体重指数、甘油三酯对数、白细胞计数对数、收缩压、总胆固醇和高密度脂蛋白胆固醇、血糖以及随机接受普伐他汀治疗是显著的预测因素。在多变量模型中，体重指数、甘油三酯对数、血糖和普伐他汀治疗被保留为该队列中糖尿病的预测因素。
我们得出结论，接受普伐他汀治疗使患糖尿病的风险降低了30%（P = 0.042）。通过降低血浆甘油三酯水平，普伐他汀治疗可能对糖尿病的发展产生有利影响，但这些分析不能排除其他解释，例如该药物的抗炎特性及其对内皮的作用。
