SynthesisPloS one2014
Lower intensified target LDL-c level of statin therapy results in a higher risk of incident diabetes: a meta-analysis.
Synthesis in PloS one, 2014. The graph read 3 numbers from its abstract, feeding 1 cell of the map: it finds no clear difference in 1. Cited by 19 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
A noticeable effect of statin therapy on new-onset diabetes was observed when their intensified target LDL-c level was lower than 1.8 mmol/L (OR 1.33, 95% CI 1.14 to 1.56; I 2 = 7.7%) and within 1.8 mmol/L to 2.59 mmol/L (OR 1.16, 95% CI 1.06 to 1.28; I 2 = 0.0%) (Figure 2).
In the combined data set, no clear association was found between standard LDL-c lowering with statin therapy and incident diabetes compared with placebo or standard care control therapy (OR 0.99, 95% CI 0.89 to 1.11) (Figure 3).
For analysis that targets LDL-c higher than 2.59 mmol/L, the result restricted to placebo-controlled trials (OR 0.95, 95% CI 0.83 to 1.08, I 2 = 0%), and the result without ALLHAT-LLT for its biggest weight (OR 0.97, 0.87 to 1.07, I 2 = 0%) was similar to the primary analysis.
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Where it lands on the map
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What it adds to each cell
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Statins×lipids
InconclusiveOpen on the map →What to test next →38 readable studies in this cell: 26 favour the treatment, 5 find no difference, 7 favour the comparator.
This paper's own estimate is on a different scale from the rest of the cell, so it is not drawn here.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
19 citing papers in PubMed, 1 synthesis or guideline pooled it, 53 citations in OpenAlex.
- Association between reductions in low-density lipoprotein cholesterol with statin therapy and the risk of new-onset diabetes: a meta-analysis.Scientific reports · 2017 · on this mapPooled it
- A dose-response relationship between low-density lipoprotein cholesterol levels within the normal range and the incidence of diabetes mellitus: a retrospective cohort study.Frontiers in endocrinology · 2026Article
- Association of body fat percentage with diabetes in hypertensive adults of different genders: a cross-sectional study.Frontiers in endocrinology · 2025Article
- Statin Use and Hyperglycemia: Do Statins Cause Diabetes?Current atherosclerosis reports · 2024Review
- Review
- Review
- Assessing the Incidence of New-onset Diabetes Mellitus with Statin Use: A Systematic Review of the Systematic Reviews and Meta-analyses.TouchREVIEWS in endocrinology · 2022Review
- Heterogeneity in statin responses explained by variation in the human gut microbiome.Med (New York, N.Y.) · 2022Article
- Review
- Diabetic dyslipidaemia.Practical laboratory medicine · 2021Review
- LDL-cholesterol change and goal attainment following statin intensity titration among Asians in primary care: a retrospective cohort study.Lipids in health and disease · 2021Article
- Impact of PCSK9 Immunization on Glycemic Indices in Diabetic Rats.Journal of diabetes research · 2021Article
- Statins and glycaemic control in type 2 diabetes: Are bile acids relevant?British journal of clinical pharmacology · 2020Article
- Statin Treatment-Induced Development of Type 2 Diabetes: From Clinical Evidence to Mechanistic Insights.International journal of molecular sciences · 2020Review
- Impaired glucagon suppression and reduced insulin sensitivity in subjects with prediabetes undergoing atorvastatin therapy.European journal of endocrinology · 2019Article
- Diabetogenic Action of Statins: Mechanisms.Current atherosclerosis reports · 2019Review
- Impact of 3-year changes in lipid parameters and their ratios on incident type 2 diabetes: Tehran lipid and glucose study.Nutrition & metabolism · 2018Article
- Interaction between Glucose and Lipid Metabolism: More than Diabetic Dyslipidemia.Diabetes & metabolism journal · 2015Review
- Risk of new-onset diabetes associated with statin use.SAGE open medicine · 2015Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
The marked sentences are the ones the graph read a number from.
backgroundA recent meta-analysis has reported that intensive-dose statin drug increases the risk of incident diabetes. However, doubling of the statin dose generates only a further 6% decrease in low-density lipoprotein cholesterol (LDL-c) on average. This study aimed to determine whether statin therapy with lower intensive-target LDL-c level contributes to higher risk of new-onset diabetes.
methodsMedline, Embase, and the Cochrane Central Register of Controlled Trials were searched for randomized controlled endpoint trials of statins conducted from 1966 to 2012. We included trials with more than 1000 participants who were followed up for at least 2 years. The included trials were stratified by the target LDL-c level. I2 statistic was used to measure heterogeneity between trials. We further calculated risk estimates with random-effect meta-analysis. Meta-regression was used to identify the potential risk factors of statin-induced diabetes.
resultsFourteen trials with a total of 95 102 non-diabetic participants were included. The risks elevated by 33% [odds ratio (OR) = 1.33; 95% confidence interval (CI) 1.14-1.56; I(2) = 7.7%] and 16% (OR = 1.16; 95% CI 1.06-1.28; I(2)= 0.0%) when the intensified target LDL-c levels were ≤ 1.8 mmol/L and 1.8-2.59 mmol/L, respectively. The risk of incident diabetes did not increase when the target LDL-c level was ≥ 2.59 mmol/L. Apart from age, female, and baseline level of total cholesterol, meta-regression analysis showed that the target and baseline levels of LDL-c and relative LDL-c reduction were predictors of statin-induced diabetes.
conclusionA lower intensified target LDL-c level of statin therapy resulted in a higher risk of incident diabetes.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.