Abstract
Background
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.
Methods
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.
Results
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.
Conclusions
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)Keywords
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Article info
Publication history
Published online: August 05, 2015
Accepted:
July 31,
2015
Received in revised form:
July 1,
2015
Received:
March 2,
2015
Identification
Copyright
© 2015 Elsevier Ireland Ltd. Published by Elsevier Inc. All rights reserved.
