Debate: Lipid-lowering Therapies and Diabetes Development.

IF 5.7 2区医学 Q1 PERIPHERAL VASCULAR DISEASE

Current Atherosclerosis Reports Pub Date : 2025-01-08 DOI:10.1007/s11883-024-01270-y

Julia Brandts, Dirk Müller-Wieland

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Abstract

Purpose of review: This review explores the relationship between lipid-lowering therapies, particularly statins, and the risk of new-onset diabetes (NOD). It examines the underlying mechanisms and evaluates whether other lipid-lowering agents present similar risks.

Recent findings: Recent meta-analyses further underscore a dose-dependent increase in NOD risk with statin therapy, particularly with high-intensity statins. In contrast to other LDL-cholesterol lowering drugs and their impact on lipid metabolism in the liver, genetic and experimental studies indicate that statins may impair insulin secretion through various mechanisms, including alterations in small G protein function, calcium signaling, and cholesterol homeostasis in pancreatic beta cells. This might contribute to the increased risk of NOD. Statins effectively reduce cardiovascular events but increase the risk of NOD, potentially via intracellular pathways affecting liver and beta-cell function. Despite the cardiovascular benefits of statins, personalized treatment strategies and alternative lipid-lowering therapies may offer safer options for patients at risk of diabetes, potentially shaping future clinical guidelines and therapeutic approaches.

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辩论：降脂疗法和糖尿病的发展。

综述目的：本综述探讨了降脂疗法，特别是他汀类药物与新发糖尿病（NOD）风险之间的关系。它检查了潜在的机制，并评估其他降脂剂是否存在类似的风险。最近的研究结果：最近的荟萃分析进一步强调了他汀类药物治疗NOD风险的剂量依赖性增加，特别是高强度他汀类药物。与其他低密度脂蛋白胆固醇降低药物及其对肝脏脂质代谢的影响不同，遗传和实验研究表明，他汀类药物可能通过多种机制损害胰岛素分泌，包括改变小G蛋白功能、钙信号传导和胰腺β细胞中的胆固醇稳态。这可能会增加NOD的风险。他汀类药物可有效减少心血管事件，但增加NOD的风险，可能通过影响肝脏和β细胞功能的细胞内途径。尽管他汀类药物对心血管有益，但个性化治疗策略和替代降脂疗法可能为有糖尿病风险的患者提供更安全的选择，可能会影响未来的临床指南和治疗方法。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Current Atherosclerosis Reports 医学-

CiteScore

9.00

自引率

3.40%

发文量

审稿时长

6-12 weeks

期刊介绍： The aim of this journal is to systematically provide expert views on current basic science and clinical advances in the field of atherosclerosis and highlight the most important developments likely to transform the field of cardiovascular prevention, diagnosis, and treatment. We accomplish this aim by appointing major authorities to serve as Section Editors who select leading experts from around the world to provide definitive reviews on key topics and papers published in the past year. We also provide supplementary reviews and commentaries from well-known figures in the field. An Editorial Board of internationally diverse members suggests topics of special interest to their country/region and ensures that topics are current and include emerging research.