Introduction: Available data suggest that prolonged and intense statin therapy does not seem to increase the risk of type 2 diabetes (DM) in the heterozygous FH (HeFH) population and that high intensity statin therapy used in the familial combined hyperlipidemia (FCH) population is not associated with increased diabetes risk compared with low intensity therapy.
Hypothesis: We assessed the incidence of DM in patients with HeFH and FCH treated with statins.
Methods: Participants (n=280, mean age 59±5 years; 90 HeFH, 112 FCH and 78 aged-matched participants) were included.
Results: The median statin intensity treatment product (statin intensity in arbitrary equivalence units x duration of statin therapy in months) was 119 and 85 for HeFH and FCH patients, respectively, at 10-year follow-up.Kaplan-Meier survival curves for new DM incidence by HeFH, FCH and control groups are illustrated in figure. The incidence of DM was significantly lower in HeFH patients compared with the FCH patients (2 vs 20%) and the reference group (2 vs 17%) during the 10-year follow-up period (all p<0.001). Impaired fasting blood glucose at entry (p<0.001) and central obesity (p=0.02) were the only independent predictors of DM.
Conclusions: The incidence of DM was significantly lower in older HeFH patients compared with either aged-matched FCH patients or individuals not receiving statins. Statins did not increase DM risk in aging FCH patients. These findings have implications given the importance of high intensity statin therapy for prevention of cardiovascular events, especially in HeFH patients, a population with high cardiovascular risk.