Atherogenic dyslipidemia increases the risk of incident diabetes in statin-treated patients with impaired fasting glucose or obesity

Abstract

Aim: To investigate which metabolic factors increase the risk of incident diabetes (T2D) in statin-treated patients.

Methods: A retrospective study conducted in Greece including 1241 consecutive individuals with dyslipidemia attending a lipid clinic for ≥3 years. After defining associations with incident T2D, we assessed the risk of new-onset T2D based on the presence of impaired fasting glucose (IFG), atherogenic dyslipidemia, and overweight/obesity.

Results: After excluding 166 patients with baseline T2D and 193 subjects taking lipid-lowering therapy at the baseline visit, 882 participants were included in the study. Eleven percent (n=94) developed T2D during their follow-up (median 6 years; IQR: 4-10). Baseline patients' age (OR: 1.05; 95% CI: 1.02-1.08, p<0.01), family history of diabetes (OR: 3.58; 95% CI: 1.86-6.91, p<0.01), IFG (OR: 6.56; 95% CI: 3.53-12.12, p<0.01), overweight/obesity (OR: 2.65; 95% CI: 1.39-5.05, p<0.01), atherogenic dyslipidemia (OR: 3.27; 95% CI: 1.50-7.15, p<0.01), and treatment with high-intensity statins (OR: 3.51; 95% CI: 1.89-6.51, p<0.01) were independently associated with increased risk of T2D in statin-treated patients. Among the IFG subjects, atherogenic dyslipidemia (OR: 3.44; 95% CI: 1.31-9.04, p=0.01) and overweight/obesity (OR: 2.54; 95% CI: 1.14-5.66, p<0.05) independently increased the risk of T2D. Among the overweight/obese ones, atherogenic dyslipidemia independently increased the risk of T2D (adjusted OR: 5.60; 95% CI: 2.19-14.30, p<0.01).

Conclusion: Atherogenic dyslipidemia appears to be an independent risk factor for new-onset T2D in statin-treated patients, while IFG, overweight/obesity and family history of diabetes remain risk factors for new-onset T2D in this group.

Keywords: Diabetes; Mixed dyslipidemia; Obesity; Prediabetes; Statin.