Rius Tarruella Joan, Millán Núñez-Cortés Jesús, Pedro-Botet Juan, Pintó Sala Xavier
Medical Affairs Cardiovascular Area, ESTEVE, Barcelona, España.
Unidad de Riesgo Cardiovascular y Lípidos, Servicio de Medicina Interna, Hospital General Universitario Gregorio Marañón, Madrid, España.
Clin Investig Arterioscler. 2015 May-Jun;27(3):148-58. doi: 10.1016/j.arteri.2015.02.001. Epub 2015 Mar 31.
Statins are the cornerstone of cardiovascular prevention for general population, and in patients with type 2 diabetes mellitus (T2DM). However, statin therapy predisposes to type 2 diabetes, particularly in patients with predisposition to this condition. Some statins have been associated with increases in blood glucose in patients with or without DM2, and others have shown to have neutral effects, varying from one another their glucose or diabetogenic capacity. In many statin trials the incidence of DM2 has not been systematically evaluated and others the power to detect differences between statins is lacking. Evidence highest quality available comes from the meta-analysis of controlled clinical trials. The only controlled clinical trial to evaluate the incidence of new-onset T2DM is the J-PREDICT conducted with pitavastatin in patients with abnormal glucose tolerance. Preliminary results of this study show that pitavastatin is associated with a significant decrease in the incidence of de novo T2DM compared to only modification lifestyle. Therefore, pitavastatin may be an appropriate therapeutic alternative of choice to reduce vascular risk in patients with T2DM or at risk of presenting it.
他汀类药物是普通人群以及2型糖尿病（T2DM）患者心血管疾病预防的基石。然而，他汀类药物治疗易引发2型糖尿病，尤其是在有患该病倾向的患者中。一些他汀类药物已被证实与糖尿病患者或非糖尿病患者的血糖升高有关，而其他一些他汀类药物则显示出中性作用，它们的血糖或致糖尿病能力各不相同。在许多他汀类药物试验中，2型糖尿病的发病率并未得到系统评估，还有一些试验缺乏检测不同他汀类药物之间差异的能力。现有最高质量的证据来自对照临床试验的荟萃分析。唯一一项评估新发T2DM发病率的对照临床试验是使用匹伐他汀对糖耐量异常患者进行的J-PREDICT试验。该研究的初步结果表明，与仅改变生活方式相比，匹伐他汀与新发T2DM发病率的显著降低相关。因此，匹伐他汀可能是降低T2DM患者或有患T2DM风险患者血管风险的合适治疗选择。
