Improving fitness lowers risk of diabetes in statin-treated dyslipidaemic patients
In statin-treated patients with dyslipidaemia, the risk of diabetes is inversely and independently associated with cardiorespiratory fitness, according to a study. Furthermore, only those with relatively low cardiorespiratory fitness have an elevated diabetes risk.
Researchers identified dyslipidaemic patients with a normal exercise test performed during 1986 and 2014 at the Veterans Affairs Medical Centers in the United States to examine the association between cardiorespiratory fitness and diabetes incidence. A total of 4,092 statin-treated patients (mean age 58.8 years; 2,701 Blacks) were included. None had evidence of type 2 diabetes (T2D) prior to statin therapy.
Four fitness categories were created based on age and peak metabolic equivalents achieved: Least-fit (n=954), Low-fit (n=1,201), Moderate-fit (n=1,242) and High-fit (n=695). Serving as controls were nonstatin-treated individuals (n=3,001; mean age 57.2 years) with no evidence of T2D prior to the exercise test.
Statin-treated patients had a 24-percent higher incidence of diabetes than nonstatin-treated participants (p<0.001). A total of 1,075 patients (26.3 percent) in the statin-treated cohort developed diabetes (average annual incidence rate, 30.6 events per 1,000 person-years).
With increasing fitness, the adjusted risk progressively decreased and was 34 percent lower for High-fit patients compared with the Least-fit (hazard ratio [HR], 0.66; 95 percent CI, 0.53 to 0.82; p<0.001) group. Compared with the nonstatin cohort, the risk of diabetes was elevated only in the Least-fit (HR, 1.50; 1.30 to 1.73; p<0.001) and Low-fit patients (HR, 1.22; 1.06 to 1.41; p=0.006).
“Improving fitness may modulate the potential diabetogenic effects of statins,” according to researchers.