• Ferran Trias, Xavier Pintó, Emili Corbella, Manuel Suárez-Tembra, Antonio Ruíz-García, José Luis Díaz-Díaz, Elena Sánchez-Ruíz-Granado, Itziar Sarasa, Raul Martínez-Porqueras, Maria Angeles Rodríguez-Sánchez, Xavier Corbella, and PRELIPID Study Group.
• Unidad de Lípidos y Riesgo Vascular, Servicio de Medicina Interna, Hospital Universitario de Bellvitge-Idibell, Spain; Fundación para la Investigación y Prevención de Enfermedades Cardiovasculares (FIPEC), Spain.
• Med Clin (Barc). 2022 Jun 10; 158 (11): 531-539.

IntroductionStatins are used with the understanding that a slightly increased risk of diabetes is outweighed by their cardiovascular benefits. However, it may be necessary to reconsider whether statin therapy really increase this risk mainly in the population with prediabetes.MethodsA multicenter, cross-sectional, observational study was conducted to assess the relationship between statin therapy and glucose metabolism in 407 patients aged 63.1 years (11SD) diagnosed with dyslipidemia and prediabetes treated in specialized lipid clinics in Spain.ResultsSignificant differences were found in HbA1c values among treatment groups (p=0.015). Patients treated with pitavastatin (1-4mg/day) showed the lowest HbA1c levels, with significant differences compared to patients treated with atorvastatin 40-80mg/day (p=0.016) and simvastatin 10-40mg/day (p=0.036). By contrast, patients treated with atorvastatin 40-80mg/day showed the highest HbA1c levels compared to those receiving atorvastatin 10-20mg/day (p=0.003), pitavastatin 1-4mg/day (p=0.016), pravastatin 20-40mg/day (p=0.027), rosuvastatin 5-10mg/day (p=0.043), and no statin treatment (p=0.004). Patients treated with simvastatin 10-40mg/day also had higher values than those treated with atorvastatin 10-20mg/day (p=0.016) and pitavastatin 1-4mg/day (p=0.036) or with no statin treatment (p=0.018).ConclusionsThis study suggests that there are differences in the diabetogenic effect of statins. Simvastatin and high doses of atorvastatin may be associated with greater impairment in glucose metabolism than pitavastatin and other statins with less lipid-lowering potency such as pravastatin.Copyright © 2021 Elsevier España, S.L.U. All rights reserved.

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