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(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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