Is Atorvastatin Associated with New Onset Diabetes or Deterioration of Glycemic Control? Systematic Review Using Data from 1.9 Million Patients

Table 1

Atorvastatin use and new onset diabetes mellitus.

Study author, year	Design	Study location	Total population (% F)	Total population: age, mean (SD), median (range/IQR)	Duration	Comparison groups	Risk of developing NOD (statin users vs nonstatin users)
Waters et al., 2011 [4, 22, 38, 95]	3 clinical trials	TNT: worldwide	TNT: 7595 (17%)	TNT: 60.6 (8.9),; NA	TNT: 4.9 years	TNT: atorvastatin 10 mg and atorvastatin 80 mg	TNT: HR: 1.10 (0.94–1.29),
		IDEAL: northern Europe	IDEAL: 7461 (19%)	IDEAL: 61.5 (9.5), NA	IDEAL: 4.8 years	IDEAL: atorvastatin 80 mg and simvastatin 20 mg	IDEAL: HR: 1.19, (0.99–1.44),
		SPARCL: worldwide	SPARCL: 3803 (41%)	SPARCL: 62.5 (11.6), NA	SPARCL: 4.9 years	SPARCL: nonstatin users and atorvastatin 80 mg	SPARCL: HR: 1.34, (1.05–1.71),
Waters et al., 2013 [1, 4, 95]	2 clinical trials	TNT: worldwide	15,056 (18%)	61.1 (9.2), NA	TNT: 4.9 years	TNT: atorvastatin 10 mg and atorvastatin 80 mg	0–1 risk factors: HR: 0.97 (0.77–1.22)
		IDEAL: northern Europe	[TNT: 7595, IDEAL: 7461]		IDEAL: 4.8 years	IDEAL: atorvastatin 80 mg and simvastatin 20 to 40 mg	2 to 4 risk factors: HR: 1.24 (1.08–1.42),
Sever et al., 2003 [26]	Clinical trial	UK, Ireland, Nordic countries	10,305 (19%)	63 (NA), NA (40–79)	3.3 years	Atorvastatin 10 mg and nonstatin users	HR: 1.15 (0.91–1.44),
Chen et al., 2013 [37]	Case control	Taiwan	11,715 (100%)	NA, NA	2 years	Atorvastatin users and nonstatin users	Adj. OR: 2.80 (1.74–4.49),
Ma et al., 2012 [14]	Retrospective cohort study	Taiwan	15,637 (NA)	74.9 (6.3), NA	5.5 years	Atorvastatin users and nonstatin users	Adj. HR: 0.77 (0.72–0.83),
Ma et al., 2012 [31]	Retrospective cohort study	Taiwan	16,027 (54%)	59.9 (18.7), NA (20–84)	3.5 years	Atorvastatin users and nonstatin users	Users vs non users: Adj. HR: 1.29 (1.16–1.44),
							Among users: Adj. HR: 1.15 (0.96–1.35),
Carter et al., 2013 [12]	Retrospective cohort study	Canada	471,250 (54%)	NA,; 73 (69–78)	12.5 years	Atorvastatin users and pravastatin users	All users: Adj. HR: 1.22 (1.15–1.29); Primary prevention users: 1.20 (1.10–1.30); Secondary prevention users: 1.25 (1.16–1.34)
Cho et al., 2015 [35]	Retrospective cohort study	Korea	3680 (52.01%)	NA, NA	62.6 (15.3) months	Atorvastatin users and simvastatin users	Adj. HR = 1.52(0.72–3.21),
Zaharan et al., 2013 [32]	Retrospective cohort study	Ireland	1,235,671 (61%)	NA, NA	8.5 years	Atorvastatin users and nonstatin users	Adj. HR: 1.25 (1.21–1.28),
Choe et al., 2014 [16]	Cohort study	Korea	394 (42%)	NA, NA	5 years	Atorvastatin users and nonstatin users	Adj. HR: 3.76 (2.22–6.40),
Culver et al., 2012 [15]	Cohort study	USA	153,840 (100%)	63.17 (7.25); NA (50–79)	NA	Atorvastatin users and nonstatin users	Adj. HR: 1.61 (1.26–2.06)
Cederberg et al., 2015 [34]	Cohort study	Finland	8749 (0%)	57 (7); 57 (45–73)	5.9 years	Atorvastatin users and nonstatin users	Adj. HR: 1.21 (1.04–1.40)
						Atorvastatin users (20 or 40 mg) and nonstatin users	HR: 1.37 (1.14–1.65)
Park et al., 2015 [36]	Cohort study	Korea	Initial: 3566 (49.41%), after PSM adjustment: 818 (49.14%)	NA, NA	3 years	Atorvastatin users (10 or 20 mg) and nonstatin users	OR: 1.99 (1.00–3.98),

Variables are expressed as absolute numbers, percentages, mean ± SD, and median (IQR). NOD: new onset diabetes mellitus; NA: not available; PSM: propensity score matching analysis; Adj. HR: adjusted hazard ratio.