Alvarez-Jimenez Laura, Morales-Palomo Felix, Moreno-Cabañas Alfonso, Ortega Juan F, Mora-Rodríguez Ricardo
Exercise Physiology Lab at Toledo, Sports Science Department, University of Castilla-La Mancha, 45004, Toledo, Spain.
Exercise Physiology Lab at Toledo, Sports Science Department, University of Castilla-La Mancha, 45004, Toledo, Spain.
Eur J Pharmacol. 2023 May 15;947:175672. doi: 10.1016/j.ejphar.2023.175672. Epub 2023 Mar 24.
AIMS: To update the evidence about the diabetogenic effect of statins. METHODS: We searched for randomized-controlled trials reporting the effects of statin therapy on glycosylated hemoglobin (HbA1c) and/or homeostatic model insulin resistance (i.e., HOMA-IR) as indexes of diabetes. Studies were classified between the ones testing normal vs individuals with already altered glycemic control (HbA1c ≥ 6.5%; and HOMA-IR ≥ 2.15). Furthermore, studies were separated by statin type and dosage prescribed. Data are presented as mean difference (MD) and 95% confidence intervals. RESULTS: A total of 67 studies were included in the analysis (>25,000 individuals). In individuals with altered glycemic control, statins increased HbA1c levels (MD 0.21%, 95% CI 0.16-to-0.25) and HOMA-IR index (MD 0.31, 95% CI 0.24-to-0.38). In individuals with normal glycemic control, statin increased HbA1c (MD 1.33%, 95% CI 1.31-to-1.35) and HOMA-IR (MD 0.49, 95% CI 0.41-to-0.58) in comparison to the placebo groups. The dose or type of statins did not modulate the diabetogenic effect. CONCLUSIONS: Statins, slightly but significantly raise indexes of diabetes in individuals with adequate or altered glycemic control. The diabetogenic effect does not seem to be influenced by the type or dosage of statin prescribed.
目的：更新有关他汀类药物致糖尿病作用的证据。 方法：我们检索了报告他汀类药物治疗对糖化血红蛋白（HbA1c）和/或稳态模型胰岛素抵抗（即HOMA-IR）作为糖尿病指标影响的随机对照试验。研究分为测试正常人与血糖控制已改变个体（HbA1c≥6.5%；HOMA-IR≥2.15）的试验。此外，研究按他汀类药物类型和规定剂量进行分类。数据以平均差（MD）和95%置信区间表示。 结果：共有67项研究纳入分析（超过25000人）。在血糖控制改变的个体中，他汀类药物增加了HbA1c水平（MD 0.21%，95%CI 0.16至0.25）和HOMA-IR指数（MD 0.31，95%CI 0.24至0.38）。在血糖控制正常的个体中，与安慰剂组相比，他汀类药物增加了HbA1c（MD 1.33%，95%CI 1.31至1.35）和HOMA-IR（MD 0.49，95%CI 0.41至0.58）。他汀类药物的剂量或类型并未调节其致糖尿病作用。 结论：他汀类药物在血糖控制良好或已改变的个体中，轻微但显著地提高了糖尿病指标。致糖尿病作用似乎不受所开他汀类药物的类型或剂量影响。
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