Jones N R V, Fischbacher C M, Guthrie B, Leese G, Lindsay R S, McKnight J A, Pearson D, Philip S, Sattar N, Wild S H
Centre for Population Health Sciences, University of Edinburgh, Edinburgh, UK.
Diabet Med. 2014 Jun;31(6):640-6. doi: 10.1111/dme.12409. Epub 2014 Mar 24.
To describe characteristics associated with statin prescribing for the primary prevention of cardiovascular disease in people with newly diagnosed diabetes.
Data from the Scottish Care Information-Diabetes Collaboration data set for 2006-2008 were used. This data set contains socio-demographic and prescribing data for over 99% of people with diagnosed diabetes in Scotland. Analyses were conducted on people aged over 40 years diagnosed with Type 1 or Type 2 diabetes between 2006 and 2008 with complete data and no previous history of cardiovascular or statin prescription. Logistic regression was used to calculate odds ratios for statin prescription in the 2 years following diagnosis of diabetes.
There were 7157 men and 5601 women who met the inclusion criteria, 68% of whom had a statin prescription recorded in the 2 years following diagnosis of diabetes. The proportions receiving statins were lower above 65 years of age in men and 75 years of age in women. People with Type 1 diabetes had lower odds of receiving statins than people with Type 2 diabetes [odds ratio (95% CI) 0.42 (0.29-0.61) for men and 0.48 (0.28-0.81) for women, after adjustment for age, BMI, smoking status, cholesterol level and deprivation]. Higher total cholesterol, BMI and being a current smoker were associated with greater odds of statin prescription.
Approximately one third of the study population had no record of statin prescription during the 2 years after diagnosis of diabetes. Cardiovascular disease risk reduction opportunities may be missed in some of these people.
描述新诊断糖尿病患者中他汀类药物用于心血管疾病一级预防的处方特征。
使用了2006 - 2008年苏格兰护理信息 - 糖尿病协作数据集的数据。该数据集包含苏格兰99%以上已诊断糖尿病患者的社会人口统计学和处方数据。对2006年至2008年间年龄在40岁以上、诊断为1型或2型糖尿病且数据完整、无心血管疾病或他汀类药物处方史的患者进行分析。采用逻辑回归计算糖尿病诊断后2年内他汀类药物处方的比值比。
有7157名男性和5601名女性符合纳入标准,其中68%在糖尿病诊断后的2年内有他汀类药物处方记录。男性65岁以上和女性75岁以上接受他汀类药物的比例较低。1型糖尿病患者接受他汀类药物的几率低于2型糖尿病患者[调整年龄、体重指数、吸烟状况、胆固醇水平和贫困程度后,男性的比值比(95%置信区间)为0.42(0.29 - 0.61),女性为0.48(0.28 - 0.81)]。总胆固醇水平较高、体重指数较高以及当前吸烟者接受他汀类药物处方的几率更大。
在糖尿病诊断后的2年中,约三分之一的研究人群没有他汀类药物处方记录。这些人中的一些人可能错失了降低心血管疾病风险的机会。