Statin therapy and risk of developing type 2 diabetes: a meta-analysis.
Statin therapy and risk of developing type 2 diabetes: a meta-analysis.
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DOI：
10.2337/dc09-0738
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发表时间：
2009-10
期刊：
影响因子：
16.2
通讯作者：
Ridker PM
中科院分区：
文献类型：
--
作者：
Rajpathak SN;Kumbhani DJ;Crandall J;Barzilai N;Alderman M;Ridker PM
虽然他汀类药物治疗可降低心血管风险，但其与糖尿病发展的关系仍存在争议。第一项研究（西苏格兰冠状动脉预防研究[WOSCOPS]）评估了这种关联，报告了一个小的保护作用，但使用非标准化的糖尿病诊断标准。然而，随后的假设检验试验的结果并不一致。本荟萃分析的目的是评估他汀类药物治疗对糖尿病的可能影响。使用特定检索词对截至2009年2月报告糖尿病数据的随机他汀类药物试验进行了系统性文献检索。除了来自WOSCOPS的假设生成数据外，还可从心脏保护研究（HPS）、普伐他汀长期干预缺血性疾病（LIPID）研究、盎格鲁-斯堪的纳维亚心脏结局试验（阿斯科特）、他汀类药物预防的合理性：一项评价瑞舒伐他汀的干预试验（JUPITER）和瑞舒伐他汀在心力衰竭中的对照多国研究（CORONA），共包括57例，593例患者，平均随访3.9年，期间累积了2，082例糖尿病事件。使用随机效应模型将加权平均值报告为风险比（RR）和95% CI。采用Q和I2统计量评估统计异质性评分。在假设检验试验的荟萃分析中，我们观察到糖尿病风险略有增加（RR 1.13 [95%CI 1.03-1.23]），没有证据表明试验间存在异质性。然而，当纳入产生假设的试验WOSCOPS（1.06 [0.93-1.25]）时，该估计值减弱且不再显著，并且还导致显著异质性（Q 11.8 [5 d.f.]，P = 0.03，I2 = 57.7%）。虽然他汀类药物治疗大大降低了血管风险，包括那些有糖尿病和糖尿病风险的人，但他汀类药物治疗与糖尿病发病的关系仍然不确定。未来的他汀类药物试验应设计为正式解决这个问题。
Although statin therapy reduces cardiovascular risk, its relationship with the development of diabetes is controversial. The first study (West of Scotland Coronary Prevention Study [WOSCOPS]) that evaluated this association reported a small protective effect but used nonstandardized criteria for diabetes diagnosis. However, results from subsequent hypothesis-testing trials have been inconsistent. The aim of this meta-analysis is to evaluate the possible effect of statin therapy on incident diabetes. A systematic literature search for randomized statin trials that reported data on diabetes through February 2009 was conducted using specific search terms. In addition to the hypothesis-generating data from WOSCOPS, hypothesis-testing data were available from the Heart Protection Study (HPS), the Long-Term Intervention with Pravastatin in Ischemic Disease (LIPID) Study, the Anglo-Scandinavian Cardiac Outcomes Trial (ASCOT), the Justification for the Use of Statins in Prevention: an Intervention Trial Evaluating Rosuvastatin (JUPITER), and the Controlled Rosuvastatin Multinational Study in Heart Failure (CORONA), together including 57,593 patients with mean follow-up of 3.9 years during which 2,082 incident diabetes cases accrued. Weighted averages were reported as risk ratios (RRs) with 95% CIs using a random-effects model. Statistical heterogeneity scores were assessed with the Q and I2 statistic. In the meta-analysis of the hypothesis-testing trials, we observed a small increase in diabetes risk (RR 1.13 [95% CI 1.03–1.23]) with no evidence of heterogeneity across trials. However, this estimate was attenuated and no longer significant when the hypothesis-generating trial WOSCOPS was included (1.06 [0.93–1.25]) and also resulted in significant heterogeneity (Q 11.8 [5 d.f.], P = 0.03, I2 = 57.7%). Although statin therapy greatly lowers vascular risk, including among those with and at risk for diabetes, the relationship of statin therapy to incident diabetes remains uncertain. Future statin trials should be designed to formally address this issue.
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影响因子：
7.3
作者：
Yada, T;Nakata, M;Kakei, M
通讯作者：
Kakei, M
DOI：
10.1016/0197-2456(86)90046-2
发表时间：
1986-09-01
期刊：
CONTROLLED CLINICAL TRIALS
影响因子：
--
作者：
DERSIMONIAN, R;LAIRD, N
通讯作者：
LAIRD, N
影响因子：
16.2
作者：
Keech, A;Colquhoun, D;Tonkin, A
通讯作者：
Tonkin, A
影响因子：
158.5
作者：
Ridker, Paul M.;Danielson, Eleanor;Glynn, Robert J.
通讯作者：
Glynn, Robert J.
影响因子：
3.5
作者：
Chamberlain, LH
通讯作者：
Chamberlain, LH