Pravastatin and the development of diabetes mellitus – Evidence for a protective treatment effect in the West of Scotland Coronary Prevention Study

Daryl Freeman, John David Norrie, N. Sattar, R. D. G. Neely, S. M. Cobbe, I. Ford, C. G. Isles, A. R. Lorimer, P. W. MacFarlane, J. H. McKillop, C. J. Packard, A. Gaw

    Research output: Contribution to journalArticle

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    Abstract

    Background-We examined the development of new diabetes mellitus in men aged 45 to 64 years during the West of Scotland Coronary Prevention Study.

    Methods and Results-Our definition of diabetes mellitus was based on the American Diabetic Association threshold of a blood glucose level of greater than or equal to7.0 mmol/L. Subjects who self-reported diabetes at baseline or had a baseline glucose level of greater than or equal to7.0 mmol/L were excluded from the analyses. A total of 5974 of the 6595 randomized subjects were included in the analysis, and 139 subjects became diabetic during the study. The baseline predictors of the transition from normal glucose control to diabetes were studied. In the univariate model, body mass index, log triglyceride, log white blood cell count, systolic blood pressure, total and HDL cholesterol, glucose, and randomized treatment assignment to pravastatin were significant predictors. In a multivariate model, body mass index, log triglyceride, glucose, and pravastatin therapy were retained as predictors of diabetes in this cohort.

    Conclusions-We concluded that the assignment to pravastatin therapy resulted in a 30% reduction (P = 0.042) in the hazard of becoming diabetic. By lowering plasma triglyceride levels, pravastatin therapy may favorably influence the development of diabetes, but other explanations, such as the anti-inflammatory properties of this drug in combination with its endothelial effects, cannot be excluded with these analyses.

    Original languageEnglish
    Pages (from-to)357-362
    Number of pages5
    JournalCirculation
    Volume103
    Issue number3
    Publication statusPublished - 2001

    Keywords

    • diabetes mellitus
    • prevention
    • lipids
    • trials
    • risk factors
    • AVERAGE CHOLESTEROL LEVELS
    • INDUCED INSULIN-RESISTANCE
    • GLUCOSE-TOLERANCE
    • RISK-FACTORS
    • MYOCARDIAL-INFARCTION
    • REDUCTASE INHIBITOR
    • HEART-DISEASE
    • OBESITY
    • HYPERCHOLESTEROLEMIA
    • METABOLISM

    Cite this

    Freeman, D., Norrie, J. D., Sattar, N., Neely, R. D. G., Cobbe, S. M., Ford, I., ... Gaw, A. (2001). Pravastatin and the development of diabetes mellitus – Evidence for a protective treatment effect in the West of Scotland Coronary Prevention Study. Circulation, 103(3), 357-362.

    Pravastatin and the development of diabetes mellitus – Evidence for a protective treatment effect in the West of Scotland Coronary Prevention Study. / Freeman, Daryl; Norrie, John David; Sattar, N.; Neely, R. D. G.; Cobbe, S. M.; Ford, I.; Isles, C. G.; Lorimer, A. R.; MacFarlane, P. W.; McKillop, J. H.; Packard, C. J.; Gaw, A.

    In: Circulation, Vol. 103, No. 3, 2001, p. 357-362.

    Research output: Contribution to journalArticle

    Freeman, D, Norrie, JD, Sattar, N, Neely, RDG, Cobbe, SM, Ford, I, Isles, CG, Lorimer, AR, MacFarlane, PW, McKillop, JH, Packard, CJ & Gaw, A 2001, 'Pravastatin and the development of diabetes mellitus – Evidence for a protective treatment effect in the West of Scotland Coronary Prevention Study', Circulation, vol. 103, no. 3, pp. 357-362.
    Freeman, Daryl ; Norrie, John David ; Sattar, N. ; Neely, R. D. G. ; Cobbe, S. M. ; Ford, I. ; Isles, C. G. ; Lorimer, A. R. ; MacFarlane, P. W. ; McKillop, J. H. ; Packard, C. J. ; Gaw, A. / Pravastatin and the development of diabetes mellitus – Evidence for a protective treatment effect in the West of Scotland Coronary Prevention Study. In: Circulation. 2001 ; Vol. 103, No. 3. pp. 357-362.
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    abstract = "Background-We examined the development of new diabetes mellitus in men aged 45 to 64 years during the West of Scotland Coronary Prevention Study.Methods and Results-Our definition of diabetes mellitus was based on the American Diabetic Association threshold of a blood glucose level of greater than or equal to7.0 mmol/L. Subjects who self-reported diabetes at baseline or had a baseline glucose level of greater than or equal to7.0 mmol/L were excluded from the analyses. A total of 5974 of the 6595 randomized subjects were included in the analysis, and 139 subjects became diabetic during the study. The baseline predictors of the transition from normal glucose control to diabetes were studied. In the univariate model, body mass index, log triglyceride, log white blood cell count, systolic blood pressure, total and HDL cholesterol, glucose, and randomized treatment assignment to pravastatin were significant predictors. In a multivariate model, body mass index, log triglyceride, glucose, and pravastatin therapy were retained as predictors of diabetes in this cohort.Conclusions-We concluded that the assignment to pravastatin therapy resulted in a 30{\%} reduction (P = 0.042) in the hazard of becoming diabetic. By lowering plasma triglyceride levels, pravastatin therapy may favorably influence the development of diabetes, but other explanations, such as the anti-inflammatory properties of this drug in combination with its endothelial effects, cannot be excluded with these analyses.",
    keywords = "diabetes mellitus, prevention, lipids, trials, risk factors, AVERAGE CHOLESTEROL LEVELS, INDUCED INSULIN-RESISTANCE, GLUCOSE-TOLERANCE, RISK-FACTORS, MYOCARDIAL-INFARCTION, REDUCTASE INHIBITOR, HEART-DISEASE, OBESITY, HYPERCHOLESTEROLEMIA, METABOLISM",
    author = "Daryl Freeman and Norrie, {John David} and N. Sattar and Neely, {R. D. G.} and Cobbe, {S. M.} and I. Ford and Isles, {C. G.} and Lorimer, {A. R.} and MacFarlane, {P. W.} and McKillop, {J. H.} and Packard, {C. J.} and A. Gaw",
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    T1 - Pravastatin and the development of diabetes mellitus – Evidence for a protective treatment effect in the West of Scotland Coronary Prevention Study

    AU - Freeman, Daryl

    AU - Norrie, John David

    AU - Sattar, N.

    AU - Neely, R. D. G.

    AU - Cobbe, S. M.

    AU - Ford, I.

    AU - Isles, C. G.

    AU - Lorimer, A. R.

    AU - MacFarlane, P. W.

    AU - McKillop, J. H.

    AU - Packard, C. J.

    AU - Gaw, A.

    PY - 2001

    Y1 - 2001

    N2 - Background-We examined the development of new diabetes mellitus in men aged 45 to 64 years during the West of Scotland Coronary Prevention Study.Methods and Results-Our definition of diabetes mellitus was based on the American Diabetic Association threshold of a blood glucose level of greater than or equal to7.0 mmol/L. Subjects who self-reported diabetes at baseline or had a baseline glucose level of greater than or equal to7.0 mmol/L were excluded from the analyses. A total of 5974 of the 6595 randomized subjects were included in the analysis, and 139 subjects became diabetic during the study. The baseline predictors of the transition from normal glucose control to diabetes were studied. In the univariate model, body mass index, log triglyceride, log white blood cell count, systolic blood pressure, total and HDL cholesterol, glucose, and randomized treatment assignment to pravastatin were significant predictors. In a multivariate model, body mass index, log triglyceride, glucose, and pravastatin therapy were retained as predictors of diabetes in this cohort.Conclusions-We concluded that the assignment to pravastatin therapy resulted in a 30% reduction (P = 0.042) in the hazard of becoming diabetic. By lowering plasma triglyceride levels, pravastatin therapy may favorably influence the development of diabetes, but other explanations, such as the anti-inflammatory properties of this drug in combination with its endothelial effects, cannot be excluded with these analyses.

    AB - Background-We examined the development of new diabetes mellitus in men aged 45 to 64 years during the West of Scotland Coronary Prevention Study.Methods and Results-Our definition of diabetes mellitus was based on the American Diabetic Association threshold of a blood glucose level of greater than or equal to7.0 mmol/L. Subjects who self-reported diabetes at baseline or had a baseline glucose level of greater than or equal to7.0 mmol/L were excluded from the analyses. A total of 5974 of the 6595 randomized subjects were included in the analysis, and 139 subjects became diabetic during the study. The baseline predictors of the transition from normal glucose control to diabetes were studied. In the univariate model, body mass index, log triglyceride, log white blood cell count, systolic blood pressure, total and HDL cholesterol, glucose, and randomized treatment assignment to pravastatin were significant predictors. In a multivariate model, body mass index, log triglyceride, glucose, and pravastatin therapy were retained as predictors of diabetes in this cohort.Conclusions-We concluded that the assignment to pravastatin therapy resulted in a 30% reduction (P = 0.042) in the hazard of becoming diabetic. By lowering plasma triglyceride levels, pravastatin therapy may favorably influence the development of diabetes, but other explanations, such as the anti-inflammatory properties of this drug in combination with its endothelial effects, cannot be excluded with these analyses.

    KW - diabetes mellitus

    KW - prevention

    KW - lipids

    KW - trials

    KW - risk factors

    KW - AVERAGE CHOLESTEROL LEVELS

    KW - INDUCED INSULIN-RESISTANCE

    KW - GLUCOSE-TOLERANCE

    KW - RISK-FACTORS

    KW - MYOCARDIAL-INFARCTION

    KW - REDUCTASE INHIBITOR

    KW - HEART-DISEASE

    KW - OBESITY

    KW - HYPERCHOLESTEROLEMIA

    KW - METABOLISM

    M3 - Article

    VL - 103

    SP - 357

    EP - 362

    JO - Circulation

    JF - Circulation

    SN - 0009-7322

    IS - 3

    ER -