Assessing the Incidence of New-onset Diabetes Mellitus with Statin Use: A Systematic Review of the Systematic Reviews and Meta-analyses.

Harmanjit Singh, Pallavi Sikarwar, Supreet Khurana, Jatin Sharma
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Abstract

Statin use has been linked with new-onset diabetes mellitus (NODM). In the present systematic review, we aimed to determine the incidence of NODM with statin use by assessing and summarizing the data generated by different systematic reviews and metaanalyses published on this topic. We conducted a systematic review of systematic reviews and meta-analyses using a pre-defined study protocol. Two authors independently performed a literature search using PubMed, Embase and the Cochrane Central Register of Controlled Trials (CENTRAL) for studies reporting data on statin use and NODM incidence and screened and extracted data for the outcomes of interest. The Assessing the Methodological Auality of Systematic Reviews 2 (AMSTAR 2) checklist was used to evaluate the quality of the included systematic reviews and meta-analyses. The initial search yielded 621 potential records, and 16 relevant systematic reviews and meta-analyses were included in the present systematic review. The included studies showed an increase in the risk of NODM with statin use. In particular, rosuvastatin and atorvastatin were associated with NODM in many systematic reviews or meta-analyses; however, pravastatin and pitavastatin were found to be associated with lower or no risk. We observed a positive trend of development of NODM with statin use became more evident with advancing years as more number of studies were added. Intensive doses of statins and use in older subjects were found to be important risk factors for NODM. Finally, the quality assessment revealed that the included systematic reviews and metaanalyses were of critically low or low quality. We concluded that statin use carries a risk of causing NODM. Statins should not be discouraged in anticipation of NODM. However, glycaemic monitoring should be encouraged with the on-going statin therapy. Furthermore, clinical studies addressing the use of statins and the incidence of NODM as their primary objective should be planned.

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评估新发糖尿病与他汀类药物的发病率:系统综述和荟萃分析的系统综述。
他汀类药物与新发糖尿病(NODM)有关。在本系统综述中,我们旨在通过评估和总结发表在该主题上的不同系统综述和荟萃分析产生的数据,确定他汀类药物使用NODM的发生率。我们使用预先定义的研究方案对系统评价和荟萃分析进行了系统评价。两位作者分别使用PubMed、Embase和Cochrane中央对照试验登记册(Central Register of Controlled Trials, Central)对报告他汀类药物使用和NODM发病率数据的研究进行文献检索,并筛选和提取感兴趣的结果数据。评估系统评价的方法学质量2 (AMSTAR 2)检查表用于评估纳入的系统评价和荟萃分析的质量。最初的检索产生了621条潜在记录,本系统评价纳入了16项相关的系统评价和荟萃分析。纳入的研究表明,使用他汀类药物会增加NODM的风险。特别是,在许多系统评价或荟萃分析中,瑞舒伐他汀和阿托伐他汀与NODM相关;然而,普伐他汀和匹伐他汀被发现与较低或无风险相关。我们观察到,随着研究数量的增加,NODM与他汀类药物使用的积极发展趋势变得越来越明显。大剂量的他汀类药物和老年受试者的使用被发现是NODM的重要危险因素。最后,质量评估显示,纳入的系统评价和荟萃分析质量极低或低。我们的结论是他汀类药物有引起NODM的风险。他汀类药物不应因预期NODM而停用。然而,血糖监测应鼓励进行他汀类药物治疗。此外,应计划将他汀类药物的使用和NODM的发生率作为其主要目标的临床研究。
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