Menopause is associated with adverse cardiometabolic changes which increase the risk of new-onset type 2 diabetes (T2DM) and cardiovascular disease (CVD). Statins are widely used for primary and secondary CVD prevention, given their beneficial effects on the lipid profile and the vessel wall. On the other hand, statins increase the risk of T2DM. This association has been evaluated mainly in mixed-gender studies, without gender-specific evaluation. This narrative review evaluates the use of statins and the related risk of new-onset T2DM among postmenopausal women. Studies that incorporated a gender-specific analysis report a higher risk of new-onset T2DM in women than in men on treatment with statins. Fewer studies evaluated female-only samples; these confirm the observed association between statin use and new-onset T2DM. Factors influencing the association between statin use and T2DM include the type and dose of statin and the baseline metabolic status. Women may benefit from stratification of their metabolic risk before initiating a statin for CVD prevention.

更年期与不良心脏代谢变化相关，从而增加新发 2 型糖尿病 (T2DM) 和心血管疾病 (CVD) 的风险。鉴于他汀类药物对血脂和血管壁的有益作用，他汀类药物被广泛用于一级和二级心血管疾病预防。另一方面，他汀类药物会增加患 T2DM 的风险。这种关联主要在混合性别研究中进行评估，没有针对特定性别的评估。这篇叙述性综述评估了他汀类药物的使用以及绝经后女性新发 T2DM 的相关风险。纳入性别特异性分析的研究报告称，接受他汀类药物治疗的女性新发 T2DM 的风险高于男性。评估女性样本的研究较少；这些证实了观察到的他汀类药物使用与新发 T2DM 之间的关联。影响他汀类药物使用与 T2DM 之间关联的因素包括他汀类药物的类型和剂量以及基线代谢状态。在开始使用他汀类药物预防心血管疾病之前，女性可能会受益于代谢风险分层。