Premium
Reduced Incidence of New‐Onset Diabetes Mellitus after Renal Transplantation with 3‐Hydroxy‐3‐Methylglutaryl‐Coenzyme A Reductase Inhibitors (Statins)
Author(s) -
Prasad G. V. Ramesh,
Kim S. Joseph,
Huang Michael,
Nash Michelle M.,
Zaltzman Jeffrey S.,
Fenton Stanley S. A.,
Cattran Daniel C.,
Cole Edward H.,
Cardella Carl J.
Publication year - 2004
Publication title -
american journal of transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.89
H-Index - 188
eISSN - 1600-6143
pISSN - 1600-6135
DOI - 10.1046/j.1600-6143.2004.00598.x
Subject(s) - medicine , diabetes mellitus , transplantation , fluvastatin , prednisone , atorvastatin , gastroenterology , renal function , statin , endocrinology , incidence (geometry) , cumulative incidence , simvastatin , physics , optics
Statins have anti‐inflammatory effects, modify endothelial function and improve peripheral insulin resistance. We hypothesized that statins influence the development of new‐onset diabetes mellitus in renal transplant recipients. The records of all previously non‐diabetic adults who received an allograft in Toronto between January 1, 1999 and December 31, 2001 were reviewed with follow‐up through December 31, 2002. All patients receiving cyclosporine or tacrolimus, mycophenolate mofetil and prednisone were included. New‐onset diabetes was diagnosed by the Canadian Diabetic Association criteria: fasting plasma glucose ≥7.0 mmol/L or 2‐h postprandial glucose ≥11.1 mmol/L on more than two occasions. Statin use prior to diabetes development was recorded along with other variables. Cox proportional hazards models analyzing statin use as a time‐dependent covariate were performed. Three hundred fourteen recipients met study criteria, of whom 129 received statins. New‐onset diabetes incidence was 16% (n = 49). Statins (p = 0.0004, HR 0.238[0.109–0.524]) and ACE inhibitors/ARB (p = 0.01, HR 0.309[0.127–0.750]) were associated with decreased risk. Prednisone dose (p = 0.0001, HR 1.007[1.003–1.010] per 1 mg/d at 3 months), weight at transplant (p = 0.02, HR 1.022[1.003–1.042] per 1 kg), black ethnicity (p = 0.02, HR 1.230[1.023–1.480]) and age ≥45 years (p = 0.01, HR 2.226[1.162–4.261]) were associated with increased diabetes. Statin use is associated with reduced new‐onset diabetes development after renal transplantation.