Statin Use is Associated With Insulin Resistance in Participants of the Canadian Multicentre Osteoporosis Study

Karen J Rees-Milton; Patrick Norman; Corinne Babiolakis; Maggie Hulbert; Mandy E Turner; Claudie Berger; Tassos P Anastassiades; Wilma M Hopman; Michael A Adams; Wendy L Powley; Rachel M Holden

doi:10.1210/jendso/bvaa057

Statin Use is Associated With Insulin Resistance in Participants of the Canadian Multicentre Osteoporosis Study

J Endocr Soc. 2020 May 15;4(8):bvaa057. doi: 10.1210/jendso/bvaa057. eCollection 2020 Aug 1.

Authors

Affiliations

¹ Department of Medicine, Queen's University, Kingston, ON.
² Kingston General Health Research Institute, Kingston, ON.
³ Department of Biomedical and Molecular Sciences, Queen's University, Kingston, ON.
⁴ Research Institute of the McGill University Health Centre, Montreal, QC.
⁵ Department of Public Health Sciences, Queen's University, Kingston, ON.
⁶ School of Computing, Queen's University, Kingston, ON.

Abstract

Context: Statins have been linked to the development of diabetes and atherosclerotic plaque calcification in patients with cardiac disease.

Objective: To determine the association between statin use and statin characteristics and insulin resistance and abdominal aortic calcification (AAC) in participants of the Canadian Multicentre Osteoporosis Study (CaMos).

Design: Observational study.

Setting: General community.

Participants: Nondiabetic participants of the Kingston CaMos site.

Intervention: Insulin resistance and AAC in statin users and nonstatin users were compared with and without the inclusion of a propensity score (PS) to be on a statin. The covariates of hypertension, sex, body mass index, smoking, kidney stones, and age that were included in the PS were selected based on clinical judgment confirmed by the statistical analysis of a difference between statin users and nonstatin users.

Main outcome measures: Insulin resistance measured by the homeostasis model assessment (HOMA-IR) and AAC assessed on lateral spine radiographs using the Framingham methodology.

Results: Using a general linear model, statin use was associated with higher levels of HOMA-IR after stratified PS adjustment (β = 1.52, [1.18-1.95], P < 0.01). Hydrophilic statin users (n = 9) and lipophilic statins users (n = 30) had higher HOMA-IR compared to nonstatin users (n = 125) ([β = 2.29, (1.43-3.68), P < 0.001] and [β = 1.36, (1.04-1.78), P < 0.05]), respectively, in general linear models after stratified PS adjustment. Statin use was associated with AAC without stratifying by PS in the Wilcoxon test, but was no longer significant when stratified by PS.

Conclusions: Statins, widely prescribed drugs to lower cholesterol, may have unintended consequences related to glucose homeostasis that could be relevant in healthy aging.

Keywords: CaMoS; calcification; insulin resistance; statins.