(Circulation. 2001;103:357.)
© 2001 American Heart Association, Inc.
Clinical Investigation and Reports |
Pravastatin and the Development of Diabetes Mellitus
Evidence for a Protective Treatment Effect in the West of Scotland Coronary Prevention Study
From the Department of Biological Sciences (D.J.F.), University of Durham, Durham, UK; Robertson Centre for Biostatistics (J.N., I.F.), University of Glasgow, Glasgow, UK; Department of Pathological Biochemistry (N.S., C.J.P., J.S., A.G.), Glasgow Royal Infirmary University NHS Trust, Glasgow, UK; Department of Clinical Biochemistry (R.D.G.N.), Dryburn Hospital, North Durham Healthcare NHS Trust, Durham, UK; Department of Medical Cardiology (S.M.C., A.R.L., P.W.M.), Glasgow Royal Infirmary, Glasgow, UK; Department of Medicine (C.I.), Dumfries and Galloway Royal Infirmary, Dumfries, UK; and University Department of Medicine (J.H.M.), Glasgow Royal Infirmary, Glasgow, UK.
Correspondence to Dr Allan Gaw, Department of Pathological Biochemistry, Glasgow Royal Infirmary University NHS Trust, Glasgow G31 2ER, UK.
Background—We examined the development of new diabetes mellitus in men aged 45 to 64 years during the West of Scotland Coronary Prevention Study.
Methods and Results—Our
definition of diabetes mellitus was based on the American Diabetic
Association threshold of a blood glucose level of 
7.0 mmol/L.
Subjects who self-reported diabetes at baseline or had a baseline
glucose level of 7.0 mmol/L were excluded from the analyses. A total
of 5974 of the 6595 randomized subjects were included in the analysis,
and 139 subjects became diabetic during the study. The baseline
predictors of the transition from normal glucose control to diabetes
were studied. In the univariate model, body mass index, log
triglyceride, log white blood cell count, systolic blood pressure,
total and HDL cholesterol, glucose, and randomized treatment assignment
to pravastatin were significant predictors. In a multivariate model,
body mass index, log triglyceride, glucose, and pravastatin therapy
were retained as predictors of diabetes in this
cohort.
Conclusions—We concluded that the assignment to pravastatin therapy resulted in a 30% reduction (P=0.042) in the hazard of becoming diabetic. By lowering plasma triglyceride levels, pravastatin therapy may favorably influence the development of diabetes, but other explanations, such as the anti-inflammatory properties of this drug in combination with its endothelial effects, cannot be excluded with these analyses.
Key Words: diabetes mellitus • prevention • lipids • trials • risk factors
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G. G. L. Biondi-Zoccai, A. Abbate, G. Liuzzo, and L. M. Biasucci Atherothrombosis, inflammation, and diabetes J. Am. Coll. Cardiol., April 2, 2003; 41(7): 1071 - 1077. [Abstract] [Full Text] [PDF]
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J. B. Marks The Daily Walk or the Daily Pill? Clin. Diabetes, April 1, 2003; 21(2): 51 - 52. [Full Text] [PDF]
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S. E. Inzucchi and R. S. Sherwin Applying the Lessons of the DPP to Clinical Practice Clin. Diabetes, April 1, 2003; 21(2): 91 - 92. [Full Text] [PDF]
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S. H. Golden, N.-Y. Wang, M. J. Klag, L. A. Meoni, and F. L. Brancati Blood Pressure in Young Adulthood and the Risk of Type 2 Diabetes in Middle Age Diabetes Care, April 1, 2003; 26(4): 1110 - 1115. [Abstract] [Full Text] [PDF]
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Z. T. Bloomgarden American Association of Clinical Endocrinologists (AACE) Consensus Conference on the Insulin Resistance Syndrome: 25-26 August 2002, Washington, DC Diabetes Care, April 1, 2003; 26(4): 1297 - 1303. [Full Text] [PDF]
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R. S. Weinstock Treating Type 2 Diabetes Mellitus: A Growing Epidemic Mayo Clin. Proc., April 1, 2003; 78(4): 411 - 413. [PDF]
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M. Wolf, L. Sandler, K. Hsu, K. Vossen-Smirnakis, J. L. Ecker, and R. Thadhani First-Trimester C-Reactive Protein and Subsequent Gestational Diabetes Diabetes Care, March 1, 2003; 26(3): 819 - 824. [Abstract] [Full Text] [PDF]
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G. J. Blake and P. M. Ridker C-reactive protein and other inflammatory risk markers in acute coronary syndromes J. Am. Coll. Cardiol., February 19, 2003; 41(4_Suppl_S): 37S - 42S. [Abstract] [Full Text] [PDF]
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Z. T. Bloomgarden Pharmacologic Treatment of Type 2 Diabetes Diabetes Care, February 1, 2003; 26(2): 526 - 533. [Full Text] [PDF]
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P. P. Simonen, H. Gylling, and T. A. Miettinen Diabetes and Cholesterol Metabolism: The succinate hypothesis Diabetes Care, February 1, 2003; 26(2): 550 - 550. [Full Text]
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 B. P. Leung, N. Sattar, A. Crilly, M. Prach, D. W. McCarey, H. Payne, R. Madhok, C. Campbell, J. A. Gracie, F. Y. Liew, et al. A Novel Anti-Inflammatory Role for Simvastatin in Inflammatory Arthritis J. Immunol., February 1, 2003; 170(3): 1524 - 1530. [Abstract] [Full Text] [PDF]
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M. Freemark Pharmacologic Approaches to the Prevention of Type 2 Diabetes in High Risk Pediatric Patients J. Clin. Endocrinol. Metab., January 1, 2003; 88(1): 3 - 13. [Full Text] [PDF]
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N. Sattar, C. G Perry, and J. R Petrie Type 2 diabetes as an inflammatory disorder The British Journal of Diabetes & Vascular Disease, January 1, 2003; 3(1): 36 - 41. [Abstract] [PDF]
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R. A Defronzo Impaired glucose tolerance: do pharmacological therapies correct the underlying metabolic disturbance? The British Journal of Diabetes & Vascular Disease, January 1, 2003; 3(1_suppl): S24 - S40. [Abstract] [PDF]
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T. S. Han, N. Sattar, K. Williams, C. Gonzalez-Villalpando, M. E.J. Lean, and S. M. Haffner Prospective Study of C-Reactive Protein in Relation to the Development of Diabetes and Metabolic Syndrome in the Mexico City Diabetes Study Diabetes Care, November 1, 2002; 25(11): 2016 - 2021. [Abstract] [Full Text] [PDF]
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J. K. Plenge, T. L. Hernandez, K. M. Weil, P. Poirier, G. K. Grunwald, S. M. Marcovina, and R. H. Eckel Simvastatin Lowers C-Reactive Protein Within 14 Days: An Effect Independent of Low-Density Lipoprotein Cholesterol Reduction Circulation, September 17, 2002; 106(12): 1447 - 1452. [Abstract] [Full Text] [PDF]
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A. J Krentz Type 2 diabetes and atherosclerotic cardiovascular disease: do they share common antecedents? The British Journal of Diabetes & Vascular Disease, September 1, 2002; 2(5): 370 - 378. [Abstract] [PDF]
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C. Mcdougall and M. Fisher Prevention of diabetes in cardiovascular studies: implications for the aetiology of type 2 diabetes The British Journal of Diabetes & Vascular Disease, September 1, 2002; 2(5): 384 - 389. [Abstract] [PDF]
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S. M. Haffner, A. S. Greenberg, W. M. Weston, H. Chen, K. Williams, and M. I. Freed Effect of Rosiglitazone Treatment on Nontraditional Markers of Cardiovascular Disease in Patients With Type 2 Diabetes Mellitus Circulation, August 6, 2002; 106(6): 679 - 684. [Abstract] [Full Text] [PDF]
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D. C. Chan, G. F. Watts, P. H. R. Barrett, L. J. Beilin, T. G. Redgrave, and T. A. Mori Regulatory Effects of HMG CoA Reductase Inhibitor and Fish Oils on Apolipoprotein B-100 Kinetics in Insulin-Resistant Obese Male Subjects With Dyslipidemia Diabetes, August 1, 2002; 51(8): 2377 - 2386. [Abstract] [Full Text] [PDF]
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J.A. Paniagua, J. Lopez-Miranda, A. Escribano, F.J. Berral, C. Marin, D. Bravo, E. Paz-Rojas, P. Gomez, M. Barcos, J.A. Moreno, et al. Cerivastatin Improves Insulin Sensitivity and Insulin Secretion in Early-State Obese Type 2 Diabetes Diabetes, August 1, 2002; 51(8): 2596 - 2603. [Abstract] [Full Text] [PDF]
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