Statins, Diabetes And Prostate Cancer

Statins are primarily used for prevention of cardiovascular disease among otherwise healthy adults. While patients typically think of statins and the heart, various studies have shown they affect the body’s response to other diseases such as diabetes and prostate cancer.

Diabetes

According to a recent article published in Medical News Today, a new study published in the journal Diabetologia suggests that statins may more significantly increase a patient’s risk of type 2 diabetes than was previously thought. While studies have been circulating since 2013 about this, the current study’s authors explain that previous studies were limited and did not result in findings applicable to the general population.

According to the article:

For their study, [Prof. Markku Laakso of the Institute of Clinical Medicine at the University of Eastern Finland and Kuopio University Hospital in Finland] and colleagues analyzed the effects of statin use on 8,749 non diabetic Caucasian men aged 45-73 years who were part of the Finland-based Metabolic Syndrome in Men (METSIM) study.

During the 5.9-year follow-up, 625 men were diagnosed with type 2 diabetes, as determined by either an oral glucose tolerance test (OGTT), an HbA1c level of at least 6.5%, or the commencement of antidiabetic medication.

The results of the analysis revealed that men who were treated with statins were at 46% higher risk of diabetes than men who were not treated with statins. This 46% increased diabetes risk was present even after adjusting for the men’s age, body mass index (BMI), waist circumference, physical activity levels, smoking status, alcohol intake, family history of diabetes and treatment with beta-blockers and diuretic medications.

The researchers also assessed changes in insulin resistance and insulin secretion among men who were treated with statins. They found that statins led to a 24% reduction in insulin sensitivity during follow-up, as well as a 12% reduction in insulin secretion.

…Based on their results, the researchers say:

“Statin therapy was associated with a 46% increased risk of type 2 diabetes after adjustment for confounding factors, suggesting a higher risk of diabetes in the general population than previously reported.

The association of statin use with increased risk of developing diabetes is most likely directly related to statins decreasing both insulin sensitivity and secretion.”

Though the study was a large one, because all of the participants were Caucasian and male, study authors suggest that their findings may not be applicable to women or other ethnicities.

Prostate Cancer

Medical experts have already identified statin use as potentially having an impact on prostate cancer outcomes. However, until now, they have not had much data on how the disease’s progression is affected by the use of statins when combined with androgen deprivation therapy (ADT). According to a recent article in Medical News Today, a new study conducted by the Dana-Farber Cancer Institute and recently published in JAMA Oncology found that statin use, when combined with ADT did slow progression of the disease.

According to the article:

Previous research has found that there may be a link between statin use and improved outcomes for prostate cancer. But researchers have not had much data on how outcome is affected by statins in combination with androgen deprivation therapy (ADT) – the “cornerstone” treatment for metastatic hormone-sensitive prostate cancer.

The researchers behind the study, from the Dana-Farber Cancer Institute in Boston, MA, investigated a transporter gene that allows various drugs and hormones to enter cells.

As well as being used by statins to enter cells, this gene – SLCO2B1 – is also used by the testosterone precursor dehydroepiandrosterone sulfate (DHEAS).

The Dana-Farber team wanted to find out whether statins would interfere with the ability of DHEAS to penetrate cells, and if so, whether this could delay resistance to ADT. To do this, the researchers analyzed statin use in 926 patients who initiated ADT for prostate cancer between 1996 and 2013.

…They found that 31% of the participants were taking a statin when they began ADT. After 6 years, the disease progressed in 70% of the patients while they were receiving ADT.

The researchers then compared the median disease progression times of patients who had been taking statins with patients who had not been taking statins. They found that the median time to disease progression among statin users was longer at 27.5 months than it was for non-users at 17.4 months.

…While the current study provides a framework for future evaluation, [Jorge D. Ramos and Dr. Evan Y. Yu, of University of Washington School of Medicine in Seattle] conclude that “the current data are not sufficient to support incorporation of statin use into clinical oncology practice for patients with prostate cancer and additional studies are required.”