Liu Wei-Ting, Lin Chin, Tsai Min-Chien, Cheng Cheng-Chung, Chen Sy-Jou, Liou Jun-Ting, Lin Wei-Shiang, Cheng Shu-Meng, Lin Chin-Sheng, Tsao Tien-Ping
Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei 11490, Taiwan.
School of Public Health, National Defense Medical Center, Taipei 11490, Taiwan.
Biomedicines. 2020 Nov 13;8(11):499. doi: 10.3390/biomedicines8110499.
Statins constitute the mainstay treatment for atherosclerotic cardiovascular disease, which is associated with the risk of new-onset diabetes mellitus (NODM). However, the effects of individual statins on the risk of NODM remain unclear. We recruited 48,941 patients taking one of the three interested statins in a tertiary hospital between 2006 and 2018. Among them, 8337 non-diabetic patients taking moderate-intensity statins (2 mg/day pitavastatin, 10 mg/day atorvastatin, and 10 mg/day rosuvastatin) were included. The pitavastatin group had a higher probability of being NODM-free than the atorvastatin and rosuvastatin groups during the 4-year follow-up (log-rank test: = 0.038). A subgroup analysis revealed that rosuvastatin had a significantly higher risk of NODM than pitavastatin among patients with coronary artery disease (CAD) (adjusted HR [aHR], 1.47, 95% confidence interval [CI], 1.05-2.05, = 0.025), hypertension (aHR, 1.26, 95% CI, 1.00-1.59, = 0.047), or chronic obstructive pulmonary disease (COPD) (aHR, 1.74, 95% CI, 1.02-2.94, = 0.04). We concluded that compared with rosuvastatin, reduced diabetogenic effects of pitavastatin were observed among patients treated with moderate-intensity statin who had hypertension, COPD, or CAD. Additional studies are required to prove the effects of different statins on the risk of NODM.
他汀类药物是动脉粥样硬化性心血管疾病的主要治疗药物,而该疾病与新发糖尿病(NODM)风险相关。然而,个别他汀类药物对NODM风险的影响仍不明确。我们在2006年至2018年期间,在一家三级医院招募了48941名服用三种感兴趣的他汀类药物之一的患者。其中,纳入了8337名服用中等强度他汀类药物(2毫克/天匹伐他汀、10毫克/天阿托伐他汀和10毫克/天瑞舒伐他汀)的非糖尿病患者。在4年随访期间,匹伐他汀组无NODM的概率高于阿托伐他汀组和瑞舒伐他汀组(对数秩检验:P = 0.03)。亚组分析显示,在冠心病(CAD)患者中,瑞舒伐他汀导致NODM的风险显著高于匹伐他汀(校正风险比[aHR],1.47,95%置信区间[CI],1.05 - 2.05,P = 0.025),高血压患者中(aHR,1.26,95% CI,1.00 - 1.59,P = 0.047),或慢性阻塞性肺疾病(COPD)患者中(aHR,1.74,95% CI,1.02 - 2.94,P = 0.04)。我们得出结论,在患有高血压、COPD或CAD的接受中等强度他汀类药物治疗的患者中,与瑞舒伐他汀相比,观察到匹伐他汀的致糖尿病作用降低。需要进一步的研究来证实不同他汀类药物对NODM风险的影响。