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评价阿托伐他汀治疗的高胆固醇血症患者的血糖状态 - 一项回顾性研究。

Evaluation of glycemic status among hypercholesterolemic patients on atorvastatin in a tertiary care hospital - A retrospective study.

机构信息

Department of Pharmacology, Government Tirunelveli Medical College, Tirunelveli¸ Tamil Nadu, India.

出版信息

Indian J Pharmacol. 2022 May-Jun;54(3):165-170. doi: 10.4103/ijp.ijp_943_20.

DOI:10.4103/ijp.ijp_943_20
PMID:35848686
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9396686/
Abstract

INTRODUCTION

Statins are effective in reducing low-density lipoprotein cholesterol and are favorable in primary and secondary prevention of cardiovascular disease. Recent large trials have linked the use of statins and increased incidence of new-onset diabetes mellitus, the possibility of worsening of glucose level in individuals with diabetes following statin therapy, and this possibility is increased with the use of atorvastatin. This study was undertaken to analyze the possibility of the diabetogenic potential of atorvastatin among hypercholesterolemic patients.

MATERIALS AND METHODS

This retrospective cohort study was conducted in the cardiology department from July 2019 to December 2019. Patients on atorvastatin for more than 6 months with normoglycemia on commencement of therapy were included. The occurrence of prediabetes or new-onset diabetes mellitus after atorvastatin therapy is the outcome of the study. Adverse drug effects to atorvastatin were also recorded and WHO-UMC causality assessment was performed. Descriptive statistics were performed for baseline and demographic characteristics.

RESULTS

Sixty study participants were included in the study. Eighteen (30%) study participants developed prediabetes with an HbA1c value of 5.97 ± 0.22 and 17 (28%) of participants developed new-onset diabetes mellitus with an HbA1c value of 7.24 ± 0.50. Atorvastatin at dose of 40 mg was found to be the most frequently prescribed dose.

CONCLUSION

Atorvastatin has a dose-dependent risk of developing new-onset diabetes mellitus. Hence, the following statin therapy glycemic status should be periodically monitored especially in patients with a large dose of atorvastatin and also in patients with higher risk factors for diabetes.

摘要

简介

他汀类药物可有效降低低密度脂蛋白胆固醇,在心血管疾病的一级和二级预防中具有优势。最近的大型试验表明,使用他汀类药物与新发糖尿病的发生率增加有关,他汀类药物治疗后糖尿病患者的血糖水平恶化的可能性,并且这种可能性随着阿托伐他汀的使用而增加。本研究旨在分析阿托伐他汀在高胆固醇血症患者中致糖尿病的可能性。

材料和方法

本回顾性队列研究于 2019 年 7 月至 2019 年 12 月在心脏病科进行。纳入了开始治疗时血糖正常且服用阿托伐他汀超过 6 个月的患者。阿托伐他汀治疗后发生糖尿病前期或新发糖尿病是本研究的结果。还记录了阿托伐他汀的药物不良反应,并进行了 WHO-UMC 因果关系评估。对基线和人口统计学特征进行了描述性统计。

结果

本研究纳入了 60 名研究参与者。18 名(30%)研究参与者的糖化血红蛋白(HbA1c)值为 5.97 ± 0.22,发展为糖尿病前期;17 名(28%)参与者的 HbA1c 值为 7.24 ± 0.50,发展为新发糖尿病。发现阿托伐他汀 40mg 剂量最常被开处。

结论

阿托伐他汀的剂量依赖性新发生糖尿病的风险。因此,在开始他汀类药物治疗后,应定期监测血糖状况,尤其是在使用大剂量阿托伐他汀的患者和糖尿病高危患者中。

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本文引用的文献

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Analysis of glycemic status in diabetes-naïve patients on statins: A hospital-based cross-sectional study.他汀类药物初治患者的血糖状态分析:一项基于医院的横断面研究。
Indian J Pharmacol. 2018 Nov-Dec;50(6):320-325. doi: 10.4103/ijp.IJP_132_18.
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Impact of lipid-lowering therapy on glycemic control and the risk for new-onset diabetes mellitus.降脂治疗对血糖控制及新发糖尿病风险的影响。
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Is Atorvastatin Associated with New Onset Diabetes or Deterioration of Glycemic Control? Systematic Review Using Data from 1.9 Million Patients.阿托伐他汀与新发糖尿病或血糖控制恶化有关吗?基于190万患者数据的系统评价
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Statin induced diabetes and its clinical implications.他汀类药物诱发的糖尿病及其临床意义。
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Obesity and statins are both independent predictors of enhanced coronary arteriolar dilation in patients undergoing heart surgery.肥胖和他汀类药物都是接受心脏手术患者冠状动脉小动脉扩张增强的独立预测因素。
J Cardiothorac Surg. 2013 Apr 30;8:117. doi: 10.1186/1749-8090-8-117.
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Am J Cardiol. 2013 Apr 15;111(8):1123-30. doi: 10.1016/j.amjcard.2012.12.037. Epub 2013 Jan 24.
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Risk of incident diabetes with intensive-dose compared with moderate-dose statin therapy: a meta-analysis.与中等剂量他汀类药物治疗相比,强化剂量他汀类药物治疗的新发糖尿病风险:一项荟萃分析。
JAMA. 2011 Jun 22;305(24):2556-64. doi: 10.1001/jama.2011.860.
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J Am Coll Cardiol. 2010 Mar 23;55(12):1209-1216. doi: 10.1016/j.jacc.2009.10.053.