Statins link with diabetes put down to weight gain
The increased risk of new-onset diabetes among patients who take statins seems to be down to the drugs’ tendency to cause weight gain at the same time as lowering cholesterol, researchers believe.
The team explored the link between statin use and type 2 diabetes in both randomised trials of statins, and studies looking at genetic variants of the enzyme targeted by statins, 3-hydroxy-3-methylglutaryl-CoA reductase (HMGCR).
Their report – published in the Lancet – said that among nearly 130,000 participants of clinical trials testing the effect of statins on heart disease and stroke, those assigned a statin instead of placebo, or higher versus lower doses of statins, had a 12% increased relative risk of developing type 2 diabetes over a four-year period, and gained an around half a pound in weight.
In addition, variants in the HMGCR gene – proxies for inhibition of the enzyme – were associated with increased body weight and waist circumference, as well as markers of impaired glucose tolerance and diabetes, in the genetic studies.
Study co-lead Dr David Preiss, from the University of Glasgow Institute of Cardiovascular and Medical Sciences, said: ‘Weight gain is a risk factor for diabetes, which might help explain the small increased risk of diabetes observed in people taking statins.’
The researchers said this should mean patients taking statins can easily offset their increased risk of diabetes by taking plenty of exercise and eating healthily.
Professor Naveed Sattar, also a co-lead author and from the same institute, said: ‘The modest increases in weight and diabetes risk seen in this study could easily be mitigated by adopting healthier diets and lifestyles. Reinforcing the importance of lifestyle changes when discussing these issues with patients would further enhance the benefit of statin treatment in preventing heart attacks and strokes.’