Niacin therapy and the risk of new-onset diabetes: a meta-analysis of randomized controlled trials

Goldie, C., Taylor, A. J., Nguyen, P., McCoy, C., Zhao, X.-Q. and Preiss, D. (2016) Niacin therapy and the risk of new-onset diabetes: a meta-analysis of randomized controlled trials. Heart, 102(3), pp. 198-203. (doi: 10.1136/heartjnl-2015-308055) (PMID:26370223)

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Abstract

Objective Previous studies have suggested that niacin treatment raises glucose levels in patients with diabetes and may increase the risk of developing diabetes. We undertook a meta-analysis of published and unpublished data from randomised trials to confirm whether an association exists between niacin and new-onset diabetes. Methods We searched Medline, EMBASE and the Cochrane Central Register of Controlled Trials, from 1975 to 2014, for randomised controlled trials of niacin primarily designed to assess its effects on cardiovascular endpoints and cardiovascular surrogate markers. We included trials with ≥50 non-diabetic participants and average follow-up of ≥24 weeks. Published data were tabulated and unpublished data sought from investigators. We calculated risk ratios (RR) for new-onset diabetes with random-effects meta-analysis. Heterogeneity between trials was assessed using the I2 statistic. Results In 11 trials with 26 340 non-diabetic participants, 1371 (725/13 121 assigned niacin; 646/13 219 assigned control) were diagnosed with diabetes during a weighted mean follow-up of 3.6 years. Niacin therapy was associated with a RR of 1.34 (95% CIs 1.21 to 1.49) for new-onset diabetes, with limited heterogeneity between trials (I2=0.0%, p=0.87). This equates to one additional case of diabetes per 43 (95% CI 30 to 70) initially non-diabetic individuals who are treated with niacin for 5 years. Results were consistent regardless of whether participants received background statin therapy (p for interaction=0.88) or combined therapy with laropiprant (p for interaction=0.52). Conclusions Niacin therapy is associated with a moderately increased risk of developing diabetes regardless of background statin or combination laropiprant therapy.

Item Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Preiss, Dr David
Authors: Goldie, C., Taylor, A. J., Nguyen, P., McCoy, C., Zhao, X.-Q., and Preiss, D.
College/School:College of Medical Veterinary and Life Sciences > School of Cardiovascular & Metabolic Health
Journal Name:Heart
Publisher:BMJ Publishing Group
ISSN:1355-6037
ISSN (Online):1468-201X
Published Online:14 September 2015
Copyright Holders:Copyright © 2015 The Authors
First Published:First published in Heart 102(3): 198-203
Publisher Policy:Reproduced under a Creative Commons License

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