Observational studyJournal of general internal medicine2016

Statin Use, Diabetes Incidence and Overall Mortality in Normoglycemic and Impaired Fasting Glucose Patients.

M Regina Castro, Gyorgy Simon, Stephen S Cha, Barbara P Yawn, L Joseph Melton, Pedro J Caraballo

Open access · bronzeAbstract readObservational Study
In one paragraph

Observational study in Journal of general internal medicine, 2016. The graph read 4 numbers from its abstract, feeding 2 cells of the map, but none could be read as for or against, so it casts no vote. It also reports 2 associations that do not count as treatment evidence, such as HR 1.24 (1.11 to 1.38) for glycemic control. Cited by 10 papers.

4numbers the graph read from it
0cells of the map it votes in
10citing papers in PubMed
5.6field-weighted citation impact, top 4% of its field
1 · What the graph read from 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.

Read, but not usablea number the graph found but could not read as for or against

Glycemic controlan association or prognostic statement, not a treatment comparison · t2dfeeds one cell of the map
HR 1.241.11 to 1.38p = 0.0001
KEY RESULTS: After a mean of 6 years of follow-up, statin use was found to be associated with an increased risk of incident diabetes in the normoglycemic (HR 1.19; 95% CI, 1.05 to 1.35; p = 0.007) and IFG groups (HR 1.24; 95%CI, 1.11 to 1.38; p = 0.0001).
All-cause mortalitycomparator not stated · t2dfeeds one cell of the map
HR 0.770.64 to 0.91p = 0.0029
At the same time, overall mortality decreased in both normoglycemic (HR 0.70; 95% CI, 0.66 to 0.80; p < 0.0001) and IFG patients (HR 0.77, 95% CI, 0.64 to 0.91; p = 0.0029) with statin use.
All-cause mortalitycomparator not stated · t2dfeeds one cell of the map
HR 0.700.66 to 0.80p < 0.0001
At the same time, overall mortality decreased in both normoglycemic (HR 0.70; 95% CI, 0.66 to 0.80; p < 0.0001) and IFG patients (HR 0.77, 95% CI, 0.64 to 0.91; p = 0.0029) with statin use.
Glycemic controlan association or prognostic statement, not a treatment comparison · t2dfeeds one cell of the map
HR 1.191.05 to 1.35p = 0.007
KEY RESULTS: After a mean of 6 years of follow-up, statin use was found to be associated with an increased risk of incident diabetes in the normoglycemic (HR 1.19; 95% CI, 1.05 to 1.35; p = 0.007) and IFG groups (HR 1.24; 95%CI, 1.11 to 1.38; p = 0.0001).

clause the extractor read what became the number

2 · Its place on the map

Where it lands on the map

Rows are treatments, columns are outcomes. The coloured squares are the cells this paper feeds, coloured by the vote it casts there. Click one to jump to what this paper adds to it.

supports the treatmentfavours the comparatorno clear differenceread, but no usable result
3 · What it changes

What it adds to each cell

For every cell the paper feeds: the belief in the claim with and without this paper, and this paper's estimate drawn against every other readable study in the cell. The ringed dot is this paper.

Statins×glycemic control

No readable resultOpen on the map →What to test next →

4 readable studies in this cell: 1 favour the treatment, 3 find no difference, 0 favour the comparator.

Belief with this paper
0.27contested · 1 family supports, 2 contradict · against placebo
Without itNot a counted family in this claim, so removing it changes nothing.
← favours the treatmentfavours the comparator →
0 · no effect
NCT002899002,340 enrolled · 2006
Δ 0.10-0.30 to 0.90
NCT01678820299 enrolled · 2012
Δ 0.19-0.14 to 0.52

This paper's own estimate is on a different scale from the rest of the cell, so it is not drawn here.

Statins×all-cause mortality

No readable resultOpen on the map →What to test next →

13 readable studies in this cell: 3 favour the treatment, 8 find no difference, 2 favour the comparator.

Belief with this paper
0.50contested · 3 families support, 2 contradict · against placebo
Without itNot a counted family in this claim, so removing it changes nothing.
← favours the treatmentfavours the comparator →
1 · no effect
NCT023442907,769 enrolled · 2015
HR 0.880.70 to 1.12
HR 1.010.91 to 1.11
NCT03944512102 enrolled · 2019
RR 0.670.37 to 1.19
RR 0.990.89 to 1.11

This paper's own estimate is on a different scale from the rest of the cell, so it is not drawn here.

4 · The registry

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.

5 · Its place in the literature

Who cites it

10 citing papers in PubMed, 28 citations in OpenAlex.

  1. Article
  2. Article
  3. Article
  4. Frequent Causal Pattern Mining: A Computationally Efficient Framework For Estimating Bias-Corrected Effects.Proceedings : ... IEEE International Conference on Big Data. IEEE International Conference on Big Data · 2019
    Article
  5. Review
  6. Article
  7. Comparison of Transcriptome Between Type 2 Diabetes Mellitus and Impaired Fasting Glucose.Medical science monitor : international medical journal of experimental and clinical research · 2016
    Article
  8. Review
  9. Article
  10. Review
6 · The record

Corrections and comments

7 · Who and what money

Authors and funding

6 authors at 5 institutions in 1 country.

M Regina CastroDepartment of Medicine, Division of Endocrinology, Mayo Clinic, Rochester, MN, USA.
Gyorgy SimonInstitute for Health Informatics, University of Minnesota, Minneapolis, MN, USA.
Stephen S ChaDepartment of Health Sciences Research, Division of Biomedical Statistics & Informatics, Mayo Clinic, Rochester, MN, USA.
Barbara P YawnDepartment of Research, Olmsted Medical Center, Rochester, MN, USA.
L Joseph MeltonDepartment of Health Sciences Research, Division of Epidemiology, Mayo Clinic, Rochester, MN, USA.
Pedro J CaraballoDepartment of Medicine, Division of General Internal Medicine, Mayo Clinic, Rochester, MN, USA. caraballo.pedro@mayo.edu.
Mayo Clinic in Florida · USMayo Clinic · USMayo Clinic in Arizona · USOlmsted Medical Center · USUniversity of Minnesota · US

Funding

MAYO CLINIC CENTER FOR TRANSLATIONAL SCIENCE ACTIVITIESUL1RR024150 · NCRR · MAYO CLINIC ROCHESTER · PI RIZZA, ROBERT A. · 2006 to 2011
$66.4M
NCRR NIH HHS UL1 RR024150
8 · The paper itself

Abstract

The marked sentences are the ones the graph read a number from.

backgroundThe association between the use of statins and the risk of diabetes and increased mortality within the same population has been a source of controversy, and may underestimate the value of statins for patients at risk.

objectiveWe aimed to assess whether statin use increases the risk of developing diabetes or affects overall mortality among normoglycemic patients and patients with impaired fasting glucose (IFG). DESIGN AND

participantsObservational cohort study of 13,508 normoglycemic patients (n = 4460; 33% taking statins) and 4563 IFG patients (n = 1865; 41% taking statin) among residents of Olmsted County, Minnesota, with clinical data in the Mayo Clinic electronic medical record and at least one outpatient fasting glucose test between 1999 and 2004. Demographics, vital signs, tobacco use, laboratory results, medications and comorbidities were obtained by electronic search for the period 1999-2004. Results were analyzed by Cox proportional hazards models, and the risk of incident diabetes and mortality were analyzed by survival curves using the Kaplan-Meier method. MAIN MEASURES: The main endpoints were new clinical diagnosis of diabetes mellitus and total mortality. KEY

resultsAfter a mean of 6 years of follow-up, statin use was found to be associated with an increased risk of incident diabetes in the normoglycemic (HR 1.19; 95% CI, 1.05 to 1.35; p = 0.007) and IFG groups (HR 1.24; 95%CI, 1.11 to 1.38; p = 0.0001). At the same time, overall mortality decreased in both normoglycemic (HR 0.70; 95% CI, 0.66 to 0.80; p < 0.0001) and IFG patients (HR 0.77, 95% CI, 0.64 to 0.91; p = 0.0029) with statin use.

conclusionIn general, recommendations for statin use should not be affected by concerns over an increased risk of developing diabetes, since the benefit of reduced mortality clearly outweighs this small (19-24%) risk.

Indexed as

AdolescentAdultAgedBlood GlucoseDatabases, FactualDiabetes Mellitus, Type 2Drug UtilizationFastingFemaleFollow-Up StudiesHumansHydroxymethylglutaryl-CoA Reductase InhibitorsIncidenceKaplan-Meier EstimateMaleMiddle AgedBlood GlucoseHydroxymethylglutaryl-CoA Reductase Inhibitorsdiabetesimpaired fasting glucosemortalityprediabetesstatins

Identifiers

PMID26850412
PMCPMC4835368
OpenAlexW2256584223

What Socratic holds

Texttitle and abstract
Read underepoch 390

Registered trials

None linked

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.