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. 2022 Jul 14;21(1):132.
doi: 10.1186/s12933-022-01566-w.

Modest effect of statins on fasting glucose in a longitudinal electronic health record based cohort

Tanushree Haldar  1 , Akinyemi Oni-Orisan  1   2 , Thomas J Hoffmann  1   3 , Catherine Schaefer  4 , Carlos Iribarren  4 , Ronald M Krauss  5 , Marisa W Medina  6 , Neil Risch  7   8   9
Affiliations

Modest effect of statins on fasting glucose in a longitudinal electronic health record based cohort

Tanushree Haldar et al. Cardiovasc Diabetol. .

Abstract

Background: Prior studies of the glycemic effect of statins have been inconsistent. Also, most studies have only considered a short duration of statin use; the effect of long-term statin use on fasting glucose (FG) has not been well examined. The aim of this work is to investigate the effect of long-term statin exposure on FG levels.

Methods: Using electronic health record (EHR) data from a large and diverse longitudinal cohort, we defined long-term statin exposure in two ways: the cumulative years of statin use (cumulative supply) and the years' supply-weighted sum of doses (cumulative dose). Simvastatin, lovastatin, atorvastatin and pravastatin were included in the analysis. The relationship between statin exposure and FG was examined using linear regression with mixed effects modeling, comparing statin users before and after initiating statins and statin never-users.

Results: We examined 593,130 FG measurements from 87,151 individuals over a median follow up of 20 years. Of these, 42,678 were never-users and 44,473 were statin users with a total of 730,031 statin prescriptions. FG was positively associated with cumulative supply of statin but not comulative dose when both measures were in the same model. While statistically significant, the annual increase in FG attributable to statin exposure was modest at only 0.14 mg/dl, with only slight and non-significant differences among statin types.

Conclusions: Elevation in FG level is associated with statin exposure, but the effect is modest. The results suggest that the risk of a clinically significant increase in FG attributable to long-term statin use is small for most individuals.

Keywords: Cohort study; Fasting glucose; Statin.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Flowchart illustrating the steps of selection of individuals and FG measurements for analysis
Fig. 2
Fig. 2
Distribution of FG (mg/dl) across different age groups for three subgroups of FG measures, filtered for all drugs
Fig. 3
Fig. 3
FG by duration of statin exposure for all statin users and two sub-groups; adjusted for age, sex, BMI, race/ethnicity and average FG during the 5 years prior to start of statin
See this image and copyright information in PMC

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