Singh Harmanjit, Sikarwar Pallavi, Khurana Supreet, Sharma Jatin
Department of Pharmacology, Government Medical College and Hospital, Chandigarh, India.
These authors have contributed equally to this work and share first authorship.
touchREV Endocrinol. 2022 Nov;18(2):96-101. doi: 10.17925/EE.2022.18.2.96. Epub 2022 Nov 29.
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.
他汀类药物的使用与新发糖尿病（NODM）有关。在本系统评价中，我们旨在通过评估和总结关于该主题发表的不同系统评价和荟萃分析所产生的数据，来确定使用他汀类药物时NODM的发生率。我们使用预先定义的研究方案对系统评价和荟萃分析进行了系统评价。两位作者独立使用PubMed、Embase和Cochrane对照试验中央注册库（CENTRAL）进行文献检索，以查找报告他汀类药物使用和NODM发生率数据的研究，并筛选和提取感兴趣结局的数据。使用系统评价方法学质量评估2（AMSTAR 2）清单来评估纳入的系统评价和荟萃分析的质量。初步检索产生了621条潜在记录，本系统评价纳入了16项相关的系统评价和荟萃分析。纳入的研究表明，使用他汀类药物会增加NODM的风险。特别是，在许多系统评价或荟萃分析中，瑞舒伐他汀和阿托伐他汀与NODM有关；然而，普伐他汀和匹伐他汀被发现与较低风险或无风险有关。随着纳入研究数量的增加，我们观察到使用他汀类药物时NODM发生的阳性趋势随着年龄的增长变得更加明显。发现高强度剂量的他汀类药物以及在老年受试者中的使用是NODM的重要危险因素。最后，质量评估显示纳入的系统评价和荟萃分析质量极低或低。我们得出结论，使用他汀类药物有导致NODM的风险。不应因预期NODM而不鼓励使用他汀类药物。然而，应鼓励在他汀类药物持续治疗期间进行血糖监测。此外，应以他汀类药物的使用和NODM的发生率作为主要目标来规划临床研究。
