Department of Endocrinology and Metabolism, Tsukuba University Hospital Mito Clinical Education and Training Center, Mito Kyodo General Hospital, Mito, Japan.
J Diabetes Investig. 2022 Sep;13(9):1567-1576. doi: 10.1111/jdi.13823. Epub 2022 May 19.
AIMS/INTRODUCTION: The importance of low-density lipoprotein cholesterol (LDL-C) in the primary prevention of cardiovascular disease has recently been reported in the population aged ≥75 years with hypercholesterolemia. Therefore, the current status of LDL-C management for primary prevention of coronary artery disease in patients aged ≥75 years with type 2 diabetes mellitus was investigated.
A total of 124 patients aged ≥75 years who had type 2 diabetes mellitus, but no coronary artery disease, were investigated. The patients' background characteristics, LDL-C, glycemic status, ankle-brachial index and cardio-ankle vascular index were compared between patients taking and not taking LDL-C-lowering agents, such as hydroxymethylglutaryl-CoA reductase inhibitors (statins) and ezetimibe. The details of the antihyperlipidemic and antidiabetic agents used in the present study were also examined.
LDL-C was significantly lower in patients taking LDL-C-lowering agents (LDLCLT[+]) than in patients not taking them (LDLCLT[-]), although LDL-C was maintained <120 mg/dL in both groups (93.0 mg/dL vs 102.1 mg/dL). Approximately half of the cases in the LDLCLT(+) group received moderate-intensity statins, with pitavastatin being the most prescribed statin. Glycated hemoglobin was significantly lower in the LDLCLT(+) group than in the LDLCLT(-) group (6.9% vs 7.3%). Sodium-glucose transporter 2 inhibitors were more frequently used in the LDLCLT(+) group than in the LDLCLT(-) group. The ankle-brachial index/cardio-ankle vascular index did not differ between the groups.
Low-density lipoprotein cholesterol was properly managed for primary prevention of coronary artery disease in patients aged ≥75 years with type 2 diabetes mellitus regardless of the presence or absence of LDL-C-lowering agents.
目的/引言：最近有研究报道，在患有高胆固醇血症的年龄≥75 岁人群中，低密度脂蛋白胆固醇（LDL-C）在心血管疾病的一级预防中具有重要意义。因此，本研究旨在调查年龄≥75 岁、患有 2 型糖尿病但无冠心病的患者中 LDL-C 管理在冠状动脉疾病一级预防中的现状。
共调查了 124 例年龄≥75 岁、患有 2 型糖尿病但无冠心病的患者。比较了服用和未服用 LDL-C 降低药物（如羟甲基戊二酰辅酶 A 还原酶抑制剂[他汀类药物]和依折麦布）的患者的背景特征、LDL-C、血糖状态、踝臂指数和心踝血管指数。还检查了本研究中使用的降脂和降糖药物的详细信息。
服用 LDL-C 降低药物（LDLCLT[+]）的患者的 LDL-C 明显低于未服用者（LDLCLT[-]），尽管两组患者的 LDL-C 均维持在<120mg/dL（93.0mg/dL 比 102.1mg/dL）。LDLCLT[+]组约一半的病例接受了中等强度的他汀类药物治疗，其中匹伐他汀是最常开的他汀类药物。LDLCLT[+]组的糖化血红蛋白明显低于 LDLCLT[-]组（6.9%比 7.3%）。LDLCLT[+]组比 LDLCLT[-]组更常使用钠-葡萄糖协同转运蛋白 2 抑制剂。两组的踝臂指数/心踝血管指数无差异。
无论是否使用 LDL-C 降低药物，年龄≥75 岁、患有 2 型糖尿病的患者均能合理管理 LDL-C 以预防冠状动脉疾病。
