Терапия статинами и риск развития сахарного диабета: дискуссия продолжается
Терапия статинами и риск развития сахарного диабета: дискуссия продолжается
Карпов Р.С., Кошельская О.А. Терапия статинами и риск развития сахарного диабета: дискуссия продолжается. Consilium Medicum. 2015; 17 (12): 28–35. DOI:10.26442/2075-1753_2015.12.28-35
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Karpov R.S., Koshelskaya O.A. Statin therapy and the risk of developing diabetes: the debate continues. Consilium Medicum. 2015; 17 (12): 28–35. DOI:10.26442/2075-1753_2015.12.28-35
Терапия статинами и риск развития сахарного диабета: дискуссия продолжается
Карпов Р.С., Кошельская О.А. Терапия статинами и риск развития сахарного диабета: дискуссия продолжается. Consilium Medicum. 2015; 17 (12): 28–35. DOI:10.26442/2075-1753_2015.12.28-35
________________________________________________
Karpov R.S., Koshelskaya O.A. Statin therapy and the risk of developing diabetes: the debate continues. Consilium Medicum. 2015; 17 (12): 28–35. DOI:10.26442/2075-1753_2015.12.28-35
Несмотря на то, что терапия статинами обладает доказанным диабетогенным воздействием, ее польза для кардиоваскулярного прогноза у пациентов высокого и очень высокого риска сердечно-сосудистых осложнений существенно перевешивает риск, связанный с возможностью развития сахарного диабета (СД). В статье представлен аналитический обзор результатов клинических исследований последних лет, посвященных изучению проблемы ассоциированных с приемом статинов СД и гипергликемии; приводятся рекомендации по профилактике диабетогенных эффектов этой терапии и дискуссионные данные, требующие дальнейшего изучения.
Ключевые слова: статины, липидснижающая терапия, новые случаи сахарного диабета, гипергликемия, сердечно-сосудистый риск.
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Despite the fact that statin therapy has proven diabetogenic impact, its benefits for cardiovascular prognosis in patients with high and very high risk of cardiovascular complications significantly outweigh the risk associated with the possibility of the development of diabetes mellitus (DM). The article presents an analytical review of the results of clinical studies in recent years on the study of the problems associated with taking statins, diabetes and hyperglycemia; provides guidelines for the prevention of diabetogenic effects of this therapy and discussion data that require further study.
Key words: statins, lipid-lowering therapy, new cases of diabetes, hyperglycemia, cardiovascular risk.
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1. ESC/EAS Guidelines for the management of dyslipidaemias. Eur Heart J 2011; 32: 1769–818.
2. Diagnostika i korrektsiia narushenii lipidnogo obmena s tsel'iu profilaktiki i lecheniia ateroskleroza. Rossiiskie rekomendatsii, V peresmotr. Ros. kardiol. zhurn. (Pril. I). 2012; 4 (96): 1–32. [in Russian]
3. Stone NJ, Robinson J, Lichtenstein AH et al. 2013 ACC/AHA Guideline on the treatment of blood cholesterol to reduce atherosclerotic cardiovascular risk in adults: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines [e-pub ahead of print]. J Am Coll Cardiol 2013. http://dx.doi.org/10/1016/j.jacc 2-13.11.002.
4. Baigent C, Keech A, Kearney PM et al. Efficacy and safety of cholesterol-lowering treatment: prospective meta-analysis of data from 90,056 participants in 14 randomised trials of statins. Lancet 2005; 366: 1267–78.
5. Baigent C, Blackwell L, Emberson J et al. Cholesterol Treatment Trialists (CTT) Collaboration. Efficacy and safety of more intensive lowering of LDL cholesterol: a meta-analysis of data from 170,000 participants in 26 randomised trials. Lancet 2010; 376: 1670–81.
6. Mills EJ, Wu P, Chong G et al. Efficacy and safety of statin treatment for cardiovascular disease: a network meta-analysis of 170,255 patients from 76 randomized trials. QJM 2011; 104: 109–24.
7. European Guidelines on cardiovascular disease prevention in clinical practice (version 2012): The Fifth Joint Task Force of the European Society of Cardiology and Other Societies on Cardiovascular Disease Prevention in Clinical Practice (constituted by representatives of nine societies and by invited experts). Developed with the special contribution of the European Association for Cardiovascular Prevention & Rehabilitation (EACPR). Eur J Prev Cardiol 2012; 19 (4): 585–667.
8. Davidson M. HDL-C and CETP inhibition: will this define the FUTURE? Curr Treatment Opin Cardiovasc Med 2012; 14: 384–90.
9. Shepherd J, Blauw GJ, Murphy MB et al. Pravastatin in elderly individuals at risk of vascular disease (PROSPER): a randomised controlled trial. Lancet 2002; 360: 1623–30.
10. Ridker PM, Danielson E, Fonseca FA et al. Rosuvastatin to prevent vascular events in men and women with elevated C-reactive protein. N Engl J Med 2008; 359: 2195–207.
11. Rajpathak SN, Kumbhani DJ, Crandall J et al. Statin therapy and developing type 2 diabetes: a meta-analysis. Diabetes Care 2009; 32 (10): 1924–9.
12. Sattar N, Preiss D, Murray HM et al. Statin and risk of incident diabetes: a collaborative meta-analysis of randomized statin trials. Lancet 2010; 375: 735–42.
13. Preiss D, Seshasai SR, Welsh P et al. Risk of incident diabetes with intensive-dose compared with moderate-dose statin therapy: a meta-analysis. JAMA 2011; 305: 2556–64.
14. Mora S, Glynn RJ, Hsia J et al. Statins for the primary prevention of cardiovascular events in women with elevated high-sensitivity C-reactive protein or dyslipidemia: results from the Justification for the Use of Statins in Prevention: An Intervention Trial Evaluating Rosuvastatin (JUPITER) and meta-analysis of women from primary prevention trials. Circulation 2010; 121: 1069–77.
15. Culver AL, Ockene IS, Balasubramanian R et al. Statin use and risk of diabetes mellitus in postmenopausal women in the Women’s Health Initiative. Arch Intern Med 2012; 172: 144–52.
16. Cai R, Yuan Y, Zhou Y et al. Lower intensified target LDL-C level of statin therapy results in a higher risk of incident diabetes: a meta-analysis. PLoS One 2014; 9 (8): e104922. doi: 10.1371/jornal.pone.0104922.
17. Chen C-W, Chen T-C, Huang K-Y et al. Differential impact of statin on new-onset diabetes in different age groups: a population-based case-control study in women from an Asian country. PLoS One 2013; 8 (8): e71817. doi:10.1371/journal.pone.0071817.
18. Waters DD, Ho JE, DeMicco DA et al. Predictors of new-onset diabetes in patients treated with atorvastatin: results from 3 large randomized clinical trials. J Am Coll Cardiol 2011; 57: 1535–45.
19. Zaharan NL, Williams D, Bennet K. Statins and risk of treated incident diabetes in a primary care population. Br J Clin Pharmacol 2012; 75 (4): 1118–24.
20. Dortmuth CR, Filion KB, Paterson JM et al. Higher potency statins and the risk of new diabetes: multicentre, observational study of administrarive databases. BMJ 2014; 348. doi: http://dx.doi.org/10.1136/bmj.g3244.
21. Macedo AF, Douglas I, Smeeth L et al. Statins and the risk of type 2 diabetes mellitus: cohort study using the UK clinical practice pesearch datalink. See comment in PubMed. Commons below BMC Cardiovasc Disord 2014; 14: 85. doi: 10.1186/1471-2261-14-85.
22. Shen L, Shah BR, Reyes EM et al. Role of diuretics, β blockers, and statins in increasing the risk of diabetes in patients with impaired glucose tolerance: reanalysis of data from the NAVIGATOR study. BMJ 2013; 347: f6745. doi:10.1136/bmj.f6745.
23. Ko DT, Wijeysundera HC, Jackevicius CA et al. Diabetes and cardiovascular events in older myocardial infarction patients prescribed intensive-dose and moderate-dose statins. Circ Cardiovasc Qual Outcomes 2013; 6: 315–22. doi: 10.1161/CIRCOUTCOMES.111.000015.
24. Wang KL, Liu CJ, Chao TF et al. Statins, risk of diabetes, and implications on outcomes in general population. J Am Coll Cardiol 2012; 60: 1231–8.
25. Waters DD, Ho JE, Boekholdt SM et al. Cardiovascular event reduction versus new-onset diabetes during atorvastatin therapy: effect of baseline risk factors for diabetes. J Am Coll Cardiol 2013; 61: 148–52.
26. Orozco IJ, Buchleitner AM, Gimenez Perez G et al. Exercise or exercise and diet for preventing type 2 diabetes mellitus. Cochrane Database Syst Rev 2008; 3. CD003054. doi:10.1002/14651858.CD003054.pub3.
27. Cardona-Morrell M, Rychetnik L, Morrell SL et al. Reduction of diabetes risk in routine clinical practice: are physical activity and nutrition interventions feasible and are the outcomes from reference trials replicable? A systematic review and meta-analysis. BMC Public Health 2010;10: 653.doi:10.1186/1471-2458-10-653.
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Авторы
Р.С.Карпов, О.А.Кошельская*
ФГБНУ НИИ кардиологии. 634012, Россия, Томск, ул. Киевская, д. 111а
*koshel@cardio-tomsk.ru
________________________________________________
R.S.Karpov, O.A.Koshelskaya*
Research Institute of Cardiology. 634012, Russian Federation, Tomsk, ul. Kievskaia, d. 111a
*koshel@cardio-tomsk.ru