一项荟萃分析研究数据显示，使用他汀类致新发糖尿病风险增加会因剂量和药物类型而有差异。研究结果1月25日在线发表于《美国心脏病学杂志》(The American Journal of Cardiology)。

与安慰剂相比，普伐他汀40 mg/d致糖尿病的风险最低(比值比1.07)。风险最高的是瑞舒伐他汀40 mg/d(比值比1.25)。中等风险的是阿托伐他汀80 mg/d(比值比1.15)。

与中等剂量方案相比，剂量较大方案致糖尿病风险普遍增加。例如，瑞舒伐他汀20 mg/d的相对风险比10 mg/d高12%。

牵头进行该研究的Eliano P. Navarese博士表示，这项荟萃分析首次明确显示“致糖尿病风险与他汀类的不同剂量及类型存在梯度相关。”

波兰彼得哥什市哥白尼大学的Navarese博士和同事研究了包括11.3万多名受试者的17项随机对照试验的数据，这些试验比较了他汀类与安慰剂或不同剂量的他汀类治疗结果。随访范围为2~6年。

在临床意义方面，Navarese博士指出，“如果这项网络荟萃分析的结果能够在效能足够的头对头比较中被证实，那将对全球数百万接受他汀类治疗的患者的管理具有重要意义。一种新的他汀类治疗方案可能会出现，那时个体化他汀类治疗有可能成为最安全有效的治疗策略。”

Meta-Analysis of Impact of Different Types and Doses of Statins on New-Onset Diabetes Mellitus.

Recent reports indicate that statins are associated with an increased risk for new-onset diabetes mellitus (DM) compared with placebo and that this relation is dose dependent. The aim of this study was to perform a comprehensive network meta-analysis of randomized controlled trials (RCTs) investigating the impact of different types and doses of statins on new-onset DM. RCTs comparing different types and doses of statins with placebo were searched for using the MEDLINE, Embase, and Cochrane databases. A search of RCTs pertinent to this meta-analysis covering the period from November 1994 to October 2012 was conducted by 2 independent investigators using the MEDLINE, Cochrane, Google Scholar, and Embase databases as well as abstracts and presentations from major cardiovascular meetings. Seventeen RCTs reporting the incidence of new-onset DM during statin treatment and including a total of 113,394 patients were identified. The RCTs compared either a statin versus placebo or high-dose versus moderate-dose statin therapy. Among different statins, pravastatin 40 mg/day was associated with the lowest risk for new-onset DM compared with placebo (odds ratio 1.07, 95% credible interval 0.86 to 1.30). Conversely, rosuvastatin 20 mg/day was numerically associated with 25% increased risk for DM compared with placebo (odds ratio 1.25, 95% credible interval 0.82 to 1.90). The impact on DM appeared to be intermediate with atorvastatin 80 mg/day compared with placebo (odds ratio 1.15, 95% credible interval 0.90 to 1.50). These findings were replicated at moderate doses. In conclusion, different types and doses of statins show different potential to increase the incidence of DM.