Familial Hypercholesterolemia (FH) is the most common monogenic disorder that causes premature coronary artery disease (CAD). Our objective was to examine the risk of new onset type 2 diabetes mellitus (T2DM) among FH patients and unaffected relatives in relation to treatment with different statins in the SAFEHEART cohort study.
This is a cross-sectional and prospective cohort study in 2558 FH and 1265 unaffected relatives with a mean follow-up of 5.9 years. Several pertinent data, such as age, gender, metabolic syndrome, lipid profile, body mass index (BMI), waist circumference, HOMA-IR, dose, duration and type of statins, were obtained and examined as predictors of incident diabetes.
The new onset diabetes was 1.7% in FH and 0.2% in non FH patients (p = 0.001). In multivariate logistic regression, age (OR 1.02, CI 95%: 1.02–1.08), HOMA-IR (OR 1.17, CI 95%: 1.03–1.33), metabolic syndrome (OR 3.3, CI 95%: 1.32–8.28) and specifically plasma glucose, as a component of metabolic syndrome (OR 15.7, CI 95%: 4.70–52.53) were significant predictors of new onset T2DM in the FH group alone. In the adjusted Cox regression model in FH group, age (HR 1.03, CI 95% 1.00–1.06, p = 0.031) and metabolic syndrome (HR 4.16, CI 95% 1.58–10.92, p = 0.004) remained significant predictors of new onset T2DM.
Our data do not support the postulated diabetogenic effect associated with high-dose statins use in our cohort of FH patients.
Abbreviations:ACVD (Atherosclerotic cardiovascular disease), Apo AI (Apolipoprotein AI), Apo B (Apolipoprotein B), BMI (Body mass index), BP (Blood pressure), CAD (Coronary artery disease), CRP (C reactive protein), FH (Familial Hypercholesterolemia), HDL-C (HDL cholesterol), HMGCR (Hydroxy-3-methylglutaryl-CoA reductase), Lp (a) (Lipoprotein (a)), LDL-C (LDL cholesterol), LDL-R (Low density lipoprotein receptor), PCSK (Proproteinconvertase-subtilisin/kexin type 9), T2DM (Type 2 diabetes mellitus), TC (Total cholesterol)
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Published online: August 05, 2015
Accepted: July 31, 2015
Received in revised form: July 1, 2015
Received: March 2, 2015
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