Association of statins with diabetes mellitus and diabetic complications: Role of confounders during follow-up

Ishak A. Mansi, Chris Frei, Ethan A. Halm, Eric M. Mortensen

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Studies have associated statin use with increased risk of diabetes and diabetic complications. These studies often ensure comparability of statin users and non-users at baseline; however, most studies neglect to consider confounders that occur during follow-up. Failure to consider these confounders, such as new medications or procedures, may result in identification of a spurious association between statins and outcomes. The objective of this study was to examine the association of statins with diabetes mellitus and diabetic complications; and to examine potential confounders during the follow-up period that might affect this relationship. We conducted a retrospective cohort study using Tricare data (from October 1, 2003 to March 31, 2012). We propensity score-matched statin users and nonusers on 115 baseline characteristics before starting statins; these characteristics would be potentially associated with the use of statins or the outcomes of interest. Outcomes included the risk of diabetes mellitus and diabetic complications. Out of 60,455 patients (10,910 statin users and 49,545 nonusers), we propensity score-matched 6728 statin users to 6728 non-users. Statin users had higher ORs for diabetes (OR 1.34, 95% CI 1.24 to 1.44) and diabetes with complications (OR 1.28, 95% CI 1.16 to 1.42). Adjustment for potential confounders that occurred during the follow-up period did not explain or diminish the association between statins and adverse outcomes. Statin users in comparison to similar non-users were more commonly diagnosed with diabetes and diabetic complications, even after adjustment for potential confounders that occurred during the follow-up period.

Original languageEnglish (US)
Pages (from-to)32-42
Number of pages11
JournalJournal of Investigative Medicine
Volume65
Issue number1
DOIs
StatePublished - Jan 1 2017

Fingerprint

Hydroxymethylglutaryl-CoA Reductase Inhibitors
Diabetes Complications
Medical problems
Diabetes Mellitus
Propensity Score
Cohort Studies

ASJC Scopus subject areas

  • Medicine(all)
  • Biochemistry, Genetics and Molecular Biology(all)

Cite this

Association of statins with diabetes mellitus and diabetic complications : Role of confounders during follow-up. / Mansi, Ishak A.; Frei, Chris; Halm, Ethan A.; Mortensen, Eric M.

In: Journal of Investigative Medicine, Vol. 65, No. 1, 01.01.2017, p. 32-42.

Research output: Contribution to journalArticle

Mansi, Ishak A. ; Frei, Chris ; Halm, Ethan A. ; Mortensen, Eric M. / Association of statins with diabetes mellitus and diabetic complications : Role of confounders during follow-up. In: Journal of Investigative Medicine. 2017 ; Vol. 65, No. 1. pp. 32-42.
@article{ab4482e8c02e43319c761e7ec4f0cb46,
title = "Association of statins with diabetes mellitus and diabetic complications: Role of confounders during follow-up",
abstract = "Studies have associated statin use with increased risk of diabetes and diabetic complications. These studies often ensure comparability of statin users and non-users at baseline; however, most studies neglect to consider confounders that occur during follow-up. Failure to consider these confounders, such as new medications or procedures, may result in identification of a spurious association between statins and outcomes. The objective of this study was to examine the association of statins with diabetes mellitus and diabetic complications; and to examine potential confounders during the follow-up period that might affect this relationship. We conducted a retrospective cohort study using Tricare data (from October 1, 2003 to March 31, 2012). We propensity score-matched statin users and nonusers on 115 baseline characteristics before starting statins; these characteristics would be potentially associated with the use of statins or the outcomes of interest. Outcomes included the risk of diabetes mellitus and diabetic complications. Out of 60,455 patients (10,910 statin users and 49,545 nonusers), we propensity score-matched 6728 statin users to 6728 non-users. Statin users had higher ORs for diabetes (OR 1.34, 95{\%} CI 1.24 to 1.44) and diabetes with complications (OR 1.28, 95{\%} CI 1.16 to 1.42). Adjustment for potential confounders that occurred during the follow-up period did not explain or diminish the association between statins and adverse outcomes. Statin users in comparison to similar non-users were more commonly diagnosed with diabetes and diabetic complications, even after adjustment for potential confounders that occurred during the follow-up period.",
author = "Mansi, {Ishak A.} and Chris Frei and Halm, {Ethan A.} and Mortensen, {Eric M.}",
year = "2017",
month = "1",
day = "1",
doi = "10.1136/jim-2016-000218",
language = "English (US)",
volume = "65",
pages = "32--42",
journal = "Journal of Investigative Medicine",
issn = "1081-5589",
publisher = "Lippincott Williams and Wilkins",
number = "1",

}

TY - JOUR

T1 - Association of statins with diabetes mellitus and diabetic complications

T2 - Role of confounders during follow-up

AU - Mansi, Ishak A.

AU - Frei, Chris

AU - Halm, Ethan A.

AU - Mortensen, Eric M.

PY - 2017/1/1

Y1 - 2017/1/1

N2 - Studies have associated statin use with increased risk of diabetes and diabetic complications. These studies often ensure comparability of statin users and non-users at baseline; however, most studies neglect to consider confounders that occur during follow-up. Failure to consider these confounders, such as new medications or procedures, may result in identification of a spurious association between statins and outcomes. The objective of this study was to examine the association of statins with diabetes mellitus and diabetic complications; and to examine potential confounders during the follow-up period that might affect this relationship. We conducted a retrospective cohort study using Tricare data (from October 1, 2003 to March 31, 2012). We propensity score-matched statin users and nonusers on 115 baseline characteristics before starting statins; these characteristics would be potentially associated with the use of statins or the outcomes of interest. Outcomes included the risk of diabetes mellitus and diabetic complications. Out of 60,455 patients (10,910 statin users and 49,545 nonusers), we propensity score-matched 6728 statin users to 6728 non-users. Statin users had higher ORs for diabetes (OR 1.34, 95% CI 1.24 to 1.44) and diabetes with complications (OR 1.28, 95% CI 1.16 to 1.42). Adjustment for potential confounders that occurred during the follow-up period did not explain or diminish the association between statins and adverse outcomes. Statin users in comparison to similar non-users were more commonly diagnosed with diabetes and diabetic complications, even after adjustment for potential confounders that occurred during the follow-up period.

AB - Studies have associated statin use with increased risk of diabetes and diabetic complications. These studies often ensure comparability of statin users and non-users at baseline; however, most studies neglect to consider confounders that occur during follow-up. Failure to consider these confounders, such as new medications or procedures, may result in identification of a spurious association between statins and outcomes. The objective of this study was to examine the association of statins with diabetes mellitus and diabetic complications; and to examine potential confounders during the follow-up period that might affect this relationship. We conducted a retrospective cohort study using Tricare data (from October 1, 2003 to March 31, 2012). We propensity score-matched statin users and nonusers on 115 baseline characteristics before starting statins; these characteristics would be potentially associated with the use of statins or the outcomes of interest. Outcomes included the risk of diabetes mellitus and diabetic complications. Out of 60,455 patients (10,910 statin users and 49,545 nonusers), we propensity score-matched 6728 statin users to 6728 non-users. Statin users had higher ORs for diabetes (OR 1.34, 95% CI 1.24 to 1.44) and diabetes with complications (OR 1.28, 95% CI 1.16 to 1.42). Adjustment for potential confounders that occurred during the follow-up period did not explain or diminish the association between statins and adverse outcomes. Statin users in comparison to similar non-users were more commonly diagnosed with diabetes and diabetic complications, even after adjustment for potential confounders that occurred during the follow-up period.

UR - http://www.scopus.com/inward/record.url?scp=85019842385&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85019842385&partnerID=8YFLogxK

U2 - 10.1136/jim-2016-000218

DO - 10.1136/jim-2016-000218

M3 - Article

C2 - 27574296

AN - SCOPUS:85019842385

VL - 65

SP - 32

EP - 42

JO - Journal of Investigative Medicine

JF - Journal of Investigative Medicine

SN - 1081-5589

IS - 1

ER -