Uso de estatinas e o risco de Diabetes Mellitus tipo 2: Revisão Baseada na Evidência

Autores

  • Susana Silva Unidade de Saúde Familiar Locomotiva - ACES Médio Tejo
  • Nuno Monteiro Unidade de Saúde Familiar Locomotiva - ACES Médio Tejo

DOI:

https://doi.org/10.5712/rbmfc11(38)1178

Palavras-chave:

Diabetes Mellitus, Tipo 2. Inibidores de Hidroximetilglutaril-CoA Redutases. Incidência.

Resumo

Objetivo: Determinar se existe relação entre o uso de estatinas e a incidência de Diabetes Melittus tipo 2 (DM2). Métodos: Foram realizadas pesquisas nas bases de dados National Guidelines Clearinghouse, Cochrane Lybrary, Trip database, PubMed e MedLine utilizando os termos MeSH “Diabetes Mellitus Type 2” e “Hydroxymethylglutaryl-CoA Reductase Inhibitors” (inibidores da HMG-CoA redutase). Foram incluídas revisões sistemáticas e meta-análises e ensaios clínicos aleatorizados e controlados que avaliassem a incidência de DM2 em utilizadores de estatinas, quando comparado com placebo. Resultados: Foram selecionados 10 artigos (1 meta-análise e 9 ensaios clínicos aleatorizados e controlados). A evidência sugere que o uso de estatinas está associado a um aumento da incidência de DM2, principalmente com doses elevadas, em relação ao placebo, na maioria dos estudos avaliados. Conclusão: O risco de incidência de DM2 deve ser considerado, especialmente quando da prescrição de estatinas a indivíduos com baixo risco cardiovascular (SOR A), embora os estudos selecionados apresentem algumas limitações (metodologia heterogênea, sendo a maioria observacional).

Downloads

Não há dados estatísticos.

Métricas

Carregando Métricas ...

Referências

Waters DD, Ho JE, DeMicco DA, Breazna A, Arsenault BJ, Wun CC, et al. Predictors of new-onset diabetes in patients treated with atorvastatin: results from 3 large randomized clinical trials. J Am Coll Cardiol. 2011;57(14):1535-45. DOI: http://dx.doi.org/10.1016/j.jacc.2010.10.047 DOI: https://doi.org/10.1016/j.jacc.2010.10.047

Sattar N, Preiss D, Murray HM, Welsh P, Buckley BM, de Craen AJ, et al. Statins and risk of incident diabetes: a collaborative meta-analysis of randomised statin trials. Lancet. 2010;375(9716):735-42. DOI: http://dx.doi.org/ 10.1007/s00125-014-3409-3.

Baker WL, Talati R, White CM, Coleman CI. Differing effect of statins on insulin sensitivity in non-diabetics: a systematic review and meta-analysis. Diabetes Res Clin Pract. 2010;87(1):98-107. DOI: http://dx.doi.org/10.1016/j.diabres.2009.10.008 DOI: https://doi.org/10.1016/j.diabres.2009.10.008

Mills EJ, Wu P, Chong G, Ghement I, Singh S, Akl EA, et al. Efficacy and safety of statin treatment for cardiovascular disease: a network meta-analysis of 170,255 patients from 76 randomized trials. QJM. 2011;104(2):109-24. DOI: http://dx.doi.org/10.1093/qjmed/hcq165 DOI: https://doi.org/10.1093/qjmed/hcq165

Ebell MH, Siwek J, Weiss BD, Woolf SH, Susman J, Ewigman B, et al. Strength of recommendation taxonomy (SORT): a patient-centered approach to grading evidence in the medical literature. Am Fam Physician. 2004;69(3):548-56. PMID: 14971837 DOI: http://dx.doi.org/10.3122/jabfm.17.1.59 DOI: https://doi.org/10.3122/jabfm.17.1.59

Navarese EP, Buffon A, Andreotti F, Kozinski M, Welton N, Fabiszak T, et al. Meta-analysis of impact of different types and doses of statins on new-onset diabetes mellitus. Am J Cardiol. 2013;111(8):1123-30. DOI: http://dx.doi.org/10.1016/j.amjcard.2012.12.037 DOI: https://doi.org/10.1016/j.amjcard.2012.12.037

Jick SS, Bradbury BD. Statins and newly diagnosed diabetes. Br J Clin Pharmacol. 2004;58(3):303-9. DOI: http://dx.doi.org/10.1111/j.1365-2125.2004.02142.x DOI: https://doi.org/10.1111/j.1365-2125.2004.02142.x

Culver AL, Ockene IS, Balasubramanian R, Olendzki BC, Sepavich DM, Wactawski-Wende J, et al. Statin use and risk of diabetes mellitus in postmenopausal women in the Women’s Health Initiative. Arch Intern Med. 2012;172(2):144-52. DOI: http://dx.doi.org/10.1001/archinternmed.2011.625 DOI: https://doi.org/10.1001/archinternmed.2011.625

Wang KL, Liu CJ, Chao TF, Huang CM, Wu CH, Chen SJ, et al. Statins, risk of diabetes, and implications on outcomes in the general population. J Am Coll Cardiol. 2012;60(14):1231-8. DOI: http://dx.doi.org/10.1016/j.jacc.2012.05.019 DOI: https://doi.org/10.1016/j.jacc.2012.05.019

Carter AA, Gomes T, Camacho X, Juurlink DN, Shah BR, Mamdani MM. Risk of incident diabetes among patients treated with statins: population based study. BMJ. 2013;346:f2610. DOI: http://dx.doi.org/10.1136/bmj.f2610 DOI: https://doi.org/10.1136/bmj.f2610

Danaei G, García Rodríguez LA, Fernandez Cantero O, Hernán MA. Statins and risk of diabetes: an analysis of electronic medical records to evaluate possible bias due to differential survival. Diabetes Care. 2013;36(5):1236-40. DOI: http://dx.doi.org/10.2337/dc12-1756 DOI: https://doi.org/10.2337/dc12-1756

Chen CW, Chen TC, Huang KY, Chou P, Chen PF, Lee CC. Differential impact of statin on new-onset diabetes in different age groups: a population-based case-control study in women from an asian country. PLoS One. 2013;8(8):e71817. DOI: http://dx.doi.org/10.1371/journal.pone.0071817 DOI: https://doi.org/10.1371/journal.pone.0071817

Ko DT, Wijeysundera HC, Jackevicius CA, Yousef A, Wang J, Tu JV. Diabetes mellitus and cardiovascular events in older patients with myocardial infarction prescribed intensive-dose and moderate-dose statins. Circ Cardiovasc Qual Outcomes. 2013;6(3):315-22. DOI: http://dx.doi.org/10.1161/CIRCOUTCOMES.111.000015 DOI: https://doi.org/10.1161/CIRCOUTCOMES.111.000015

Dormuth CR, Filion KB, Paterson JM, James MT, Teare GF, Raymond CB, et al.; Canadian Network for Observational Drug Effect Studies Investigators. Higher potency statins and the risk of new diabetes: multicentre, observational study of administrative databases. BMJ. 2014;348:g3244. DOI: http://dx.doi.org/10.1136/bmj.g3244 DOI: https://doi.org/10.1136/bmj.g3244

Macedo AF, Douglas I, Smeeth L, Forbes H, Ebrahim S. Statins and the risk of type 2 diabetes mellitus: cohort study using the UK clinical practice pesearch datalink. BMC Cardiovasc Disord. 2014;14:85. DOI: http://dx.doi.org/10.1186/1471-2261-14-85 DOI: https://doi.org/10.1186/1471-2261-14-85

Koh KK, Lim S, Sakuma I, Quon MJ. Caveats to aggressive lowering of lipids by specific statins. Int J Cardiol. 2012;154(2):97-101. DOI: http://dx.doi.org/10.1016/j.ijcard.2011.09.002 DOI: https://doi.org/10.1016/j.ijcard.2011.09.002

Sampson UK, Linton MF, Fazio S. Are statins diabetogenic? Curr Opin Cardiol. 2011;26(4):342-7. DOI: http://dx.doi.org/10.4093/dmj.2013.37.6.415. DOI: https://doi.org/10.4093/dmj.2013.37.6.415

Goldfine AB. Statins: is it really time to reassess benefits and risks? N Engl J Med. 2012;366(19):1752-5. DOI: http://dx.doi.org/10.14496/dia.41040851167.17. DOI: https://doi.org/10.14496/dia.41040851167.17

Pani LN, Nathan DM, Grant RW. Clinical predictors of disease progression and medication initiation in untreated patients with type 2 diabetes and A1C less than 7%. Diabetes Care. 2008;31(3):386-90. DOI: http://dx.doi.org/10.2337/dc07-1934 DOI: https://doi.org/10.2337/dc07-1934

Nichols GA, Hillier TA, Brown JB. Progression from newly acquired impaired fasting glusose to type 2 diabetes. Diabetes Care. 2007;30(2):228-33. DOI: http://dx.doi.org/10.2337/dc09-0896. DOI: https://doi.org/10.2337/dc09-0896

Fonseca VA. Defining and characterizing the progression of type 2 diabetes. Diabetes Care. 2009;32 Suppl 2:S151-6. DOI: http://dx.doi.org/10.2337/dc09-S301 DOI: https://doi.org/10.2337/dc09-S301

Downloads

Publicado

2016-08-19

Como Citar

1.
Silva S, Monteiro N. Uso de estatinas e o risco de Diabetes Mellitus tipo 2: Revisão Baseada na Evidência. Rev Bras Med Fam Comunidade [Internet]. 19º de agosto de 2016 [citado 22º de dezembro de 2024];11(38):1-8. Disponível em: https://rbmfc.org.br/rbmfc/article/view/1178

Edição

Seção

ARTIGOS DE REVISÃO

Plaudit