Physically Fit Adults Less Likely to Develop Statin-Induced Diabetes

NEW ORLEANS — Veterans taking cholesterol-reducing statins are at risk for developing type 2 diabetes, but this risk can be mitigated through increased physical fitness, researchers reported at the American Heart Association’s Scientific Sessions 2016.

“High levels of physical fitness were protective against development of statin-induced type 2 diabetes in this high-risk veteran population,” Puneet Narayan, MD, from the Department of Veterans Affairs Medical Center in Washington, DC, and colleagues wrote in their study abstract.

Dr Narayan and colleagues evaluated 5143 veterans at risk for type 2 diabetes with a mean age of 58.9 years who underwent a baseline exercise tolerance program to establish their fitness level. After the tolerance test, the researchers divided the veterans into age-stratified quintiles of peak metabolic equivalents (METs), which included 1007 patients who were in the least-fit group (4.5 ± 1.1 METs), 1159 patients in the low-fit group (6.2 ± 1.1 METs), 1061 patients in the moderately-fit group (7.3 ± 1.2 METs), 1073 patients in the fit group (8.4 ± 1.1 METs), and 843 patients in the highly-fit group (11.0 ± 2.3 METs), according to the abstract.

After beginning statin therapy, they used multivariable Cox models at 10.01-year follow-up to estimate hazard ratios (HRs) and adjust for factors such as age, gender, body mass index, race, hypertension, medications, resting blood pressure, and smoking status.

The researchers found 1110 patients developed diabetes after beginning statin therapy (21.5 events per 1000 person-years).

“The association between fitness status and incidence of [diabetes] was inverse and graded,” Dr Narayan and colleagues wrote.

Specifically, each 1-MET increase was associated with an 8% decreased risk of developing diabetes (HR: 0.92; 95% CI, 0.89- 0.94), with patients in the 3 lower fitness categories having the highest risk for developing diabetes. Patients in the fit group had a 22% lower risk with a peak exercise capacity of 8.4 ± 1.1 METs (HR: 0.78; 95% CI, 0.64- 0.94), while patients in the highly-fit group had a 42% lower risk with a peak exercise capacity of 11.0 ± 2.3 METs (HR: 0.58; 95% CI, 0.46- 0.73).

Disclosures: Dr Narayan participates in ongoing clinical research protocols funded by Eli Lilly, AstraZeneca, and Pfizer.

Reference

1. Narayan P, Li J, Faselis C, Kumar A, et al. Abstract 606. Role of Physical Fitness in Statin Induced Type II Diabetes Mellitus. Presented at: American Heart Association’s Scientific Sessions 2016; November 12–16, 2016; New Orleans, LA.