Department of Public Health, China Medical University, No. 91, Hsueh-Shih Road, Taichung 404327, Taiwan.
Centers for Disease Control Ministry of Health and Welfare, Taichung 40855, Taiwan.
Int J Environ Res Public Health. 2022 Oct 23;19(21):13770. doi: 10.3390/ijerph192113770.
Statin therapy can effectively reduce recurrent transient ischemic attack (TIA) risk. However, studies have reported that statin use is associated with incidence of diabetes mellitus (DM). Whether statin therapy remains associated with higher DM risk in patients with TIA remains unknown. This study investigated whether statin treatment influences incident DM risk in patients with TIA. We conducted a retrospective cohort study using the Longitudinal Health Insurance Database 2000. Participants who were newly diagnosed with TIA (ICD-9-CM code 435) from 1 January 1997 to 31 December 2011 were recruited. The Kaplan-Meier method and Cox proportional risk model of time-dependent covariance were used. We enrolled 8342 patients with newly diagnosed TIA from 1 January 1997 to 31 December 2011. Of these, 1255 patients were classified as statin users and 7087 as nonusers. During the 14-year follow-up, the incidence of newly diagnosed DM was 0.545-fold lower in the statins group compared with nonusers (95% confidence interval [CI] = 0.457-0.650). According to cumulative defined daily doses (cDDDs), the adjusted hazard ratios for DM were 0.689, 0.594, and 0.463 when patients were treated with statins at cDDDs = 28-89, 90-180, and >180, respectively. In patients with TIA, statin use is associated with a lower incident DM risk compared with the nonuse of statins.
他汀类药物治疗可有效降低复发性短暂性脑缺血发作（TIA）的风险。然而，有研究报告称，他汀类药物的使用与糖尿病（DM）的发病率有关。在 TIA 患者中，他汀类药物治疗是否仍与更高的 DM 风险相关尚不清楚。本研究旨在探讨他汀类药物治疗是否会影响 TIA 患者的新发 DM 风险。我们进行了一项回顾性队列研究，使用了纵向健康保险数据库 2000。参与者为 1997 年 1 月 1 日至 2011 年 12 月 31 日期间新诊断为 TIA（ICD-9-CM 编码 435）的患者。采用 Kaplan-Meier 方法和时间依赖性协方差 Cox 比例风险模型。我们共纳入了 1997 年 1 月 1 日至 2011 年 12 月 31 日期间新诊断为 TIA 的 8342 例患者。其中，1255 例患者被归类为他汀类药物使用者，7087 例为非使用者。在 14 年的随访期间，他汀类药物组新发 DM 的发病率较非使用者低 0.545 倍（95%置信区间[CI] = 0.457-0.650）。根据累积定义日剂量（cDDD），当患者的他汀类药物治疗剂量分别为 cDDD=28-89、90-180 和>180 时，DM 的调整后的危害比分别为 0.689、0.594 和 0.463。在 TIA 患者中，与不使用他汀类药物相比，使用他汀类药物与新发 DM 风险降低相关。
