Departments of Internal Medicine, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, 150, Seongan-ro, Gangdong-gu, Seoul, 05355, South Korea.
Institute for Liver and Digestive Diseases, Hallym University, Chuncheon, South Korea.
Cardiovasc Diabetol. 2022 May 23;21(1):82. doi: 10.1186/s12933-022-01524-6.
Statin treatment increases the risk of new-onset diabetes mellitus (NODM); however, data directly comparing the risk of NODM among individual statins is limited. We compared the risk of NODM between patients using pitavastatin and atorvastatin or rosuvastatin using reliable, large-scale data.
Data of electronic health records from ten hospitals converted to the Observational Medical Outcomes Partnership Common Data Model (n = 14,605,368 patients) were used to identify new users of pitavastatin, atorvastatin, or rosuvastatin (atorvastatin + rosuvastatin) for ≥ 180 days without a previous history of diabetes or HbA1c level ≥ 5.7%. We conducted a cohort study using Cox regression analysis to examine the hazard ratio (HR) of NODM after propensity score matching (PSM) and then performed an aggregate meta-analysis of the HR.
After 1:2 PSM, 10,238 new pitavastatin users (15,998 person-years of follow-up) and 18,605 atorvastatin + rosuvastatin users (33,477 person-years of follow-up) were pooled from 10 databases. The meta-analysis of the HRs demonstrated that pitavastatin resulted in a significantly reduced risk of NODM than atorvastatin + rosuvastatin (HR 0.72; 95% CI 0.59-0.87). In sub-analysis, pitavastatin was associated with a lower risk of NODM than atorvastatin or rosuvastatin after 1:1 PSM (HR 0.69; CI 0.54-0.88 and HR 0.74; CI 0.55-0.99, respectively). A consistently low risk of NODM in pitavastatin users was observed when compared with low-to-moderate-intensity atorvastatin + rosuvastatin users (HR 0.78; CI 0.62-0.98).
In this retrospective, multicenter active-comparator, new-user, cohort study, pitavastatin reduced the risk of NODM compared with atorvastatin or rosuvastatin.
他汀类药物治疗会增加新发糖尿病（NODM）的风险；然而，直接比较各种他汀类药物发生 NODM 风险的数据十分有限。我们使用可靠的大规模数据比较了匹伐他汀与阿托伐他汀或瑞舒伐他汀使用者发生 NODM 的风险。
我们使用来自十家医院的电子健康记录数据（Observation Medical Outcomes Partnership Common Data Model，OMOP CDM）（n=14605368 名患者），纳入无糖尿病史或糖化血红蛋白（HbA1c）水平≥5.7%且使用匹伐他汀、阿托伐他汀或瑞舒伐他汀（阿托伐他汀+瑞舒伐他汀）治疗≥180 天的新使用者。我们通过 Cox 回归分析进行队列研究，以评估倾向评分匹配（PSM）后的 NODM 风险比（HR），然后对 HR 进行汇总荟萃分析。
在 1:2 PSM 后，我们从 10 个数据库中纳入了 10238 名新匹伐他汀使用者（15998 人年随访）和 18605 名阿托伐他汀+瑞舒伐他汀使用者（33477 人年随访）。HR 的荟萃分析显示，匹伐他汀降低 NODM 的风险显著低于阿托伐他汀+瑞舒伐他汀（HR 0.72；95%CI 0.59-0.87）。亚组分析显示，1:1 PSM 后，匹伐他汀与阿托伐他汀或瑞舒伐他汀相比，NODM 的风险更低（HR 0.69；CI 0.54-0.88 和 HR 0.74；CI 0.55-0.99）。与低-中强度阿托伐他汀+瑞舒伐他汀使用者相比，匹伐他汀使用者发生 NODM 的风险一直较低（HR 0.78；CI 0.62-0.98）。
在这项回顾性、多中心、活性对照、新使用者队列研究中，与阿托伐他汀或瑞舒伐他汀相比，匹伐他汀降低了 NODM 的风险。
