Pravastatin and the development of diabetes mellitus - Evidence for a protective treatment effect in the West of Scotland Coronary Prevention Study

Background-We examined the development of new diabetes mellitus in men aged 45 to 64 years during the West of Scotland Coronary Prevention Study. Methods and Results-Our definition of diabetes mellitus was based on the Am erican Diabetic Association threshold of a blood glucose level of greater t han or equal to7.0 mmol/L. Subjects who self-reported diabetes at baseline or had a baseline glucose level of greater than or equal to7.0 mmol/L were excluded from the analyses. A total of 5974 of the 6595 randomized subjects were included in the analysis, and 139 subjects became diabetic during the study. The baseline predictors of the transition from normal glucose contr ol to diabetes were studied. In the univariate model, body mass index, log triglyceride, log white blood cell count, systolic blood pressure, total an d HDL cholesterol, glucose, and randomized treatment assignment to pravasta tin were significant predictors. In a multivariate model, body mass index, log triglyceride, glucose, and pravastatin therapy were retained as predict ors of diabetes in this cohort. Conclusions-We concluded that the assignment to pravastatin therapy resulte d in a 30% reduction (P = 0.042) in the hazard of becoming diabetic. By low ering plasma triglyceride levels, pravastatin therapy may favorably influen ce the development of diabetes, but other explanations, such as the anti-in flammatory properties of this drug in combination with its endothelial effe cts, cannot be excluded with these analyses.