HoldsUp

Ronald Krauss

Children’s Hospital Oakland Research Institute

Ronald Krauss, M.D., is the director of atherosclerosis research at Children’s Hospital Oakland Research Institute and an adjunct professor at UCSF and UC Berkeley. His research focuses on lipid metabolism, having developed an assay to quantify low-density lipoprotein (LDL) particle size and concentration. His published work covers dietary effects on cardiometabolic disease and insulin sensitivity, statin responses, and the relationship between cholesterol regulation, genetics, and Alzheimer's disease.

38 claims checked on air: 2 context 2 overstated 33 supported 1 unverified 2 flagged

What they said on air - overstated

2 citing their own research

1:02:07overstatedhighDr. Ronald Krauss on LDL Cholesterol, Particle Size, Heart D

Statins cause an approximate 11% to 12% increased risk of developing type 2 diabetes among users.

"The magnitude of that effect turns out to be surprisingly high. It's um something on the order of 11 to 12% of statin users um are at risk for developing type 2 diabetes." (said at 1:02:07)

Meta-analyses of large randomized controlled trials demonstrate that statin therapy is associated with a ~9% to 12% relative risk increase in new-onset type 2 diabetes (e.g., Sattar et al. 2010 found an OR of 1.09; Preiss et al. 2011 found an OR of 1.12 for intensive vs. moderate statin therapy; CTT Collaboration 2024 found an RR of 1.10 for low-to-moderate intensity statins). However, the speaker states that '11 to 12% of statin users are at risk for developing type 2 diabetes', conflating a relative risk increase (~11-12%) with the absolute proportion of users who develop diabetes. In absolute terms, statins increase the incidence of diabetes by only ~0.1% to 0.2% per year (1 additional case per 255 to 500 patients treated over 4–5 years), primarily in individuals who already have pre-existing risk factors or elevated baseline glycaemia.

1:02:20overstatedhighDr. Ronald Krauss on LDL Cholesterol, Particle Size, Heart D

In women, the risk of developing type 2 diabetes from statin therapy can be up to three or four times higher, reaching as many as 30% to 40% in otherwise healthy women.

"In women in particular—we published the paper that sort of opened this up, actually—um in women, the evidence is that may be two or three or four times that. It may be as many as 30 to 40% of otherwise healthy women who are put on statins um uh could go on to develop type 2 diabetes over over time." (said at 1:02:20)

The speaker references the landmark Women's Health Initiative (WHI) study led by Culver et al. (2012), but significantly overstates both the relative and absolute risks. In the WHI paper, statin use among postmenopausal women was associated with a 48% increase in risk (multivariate-adjusted HR 1.48, 95% CI 1.38–1.59; unadjusted HR 1.71), not a 2- to 4-fold (200% to 400%) increase. Furthermore, the absolute rate of incident diabetes in statin users in this cohort was far below the claimed 30% to 40%. Large meta-analyses of randomized controlled trials (such as CTT Collaboration 2024) confirm a much smaller relative increase: 10% for low-to-moderate-intensity statins (RR 1.10) and 36% for high-intensity statins (RR 1.36), occurring primarily in individuals who already have elevated baseline glycemic risk factors.

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