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他汀类药物治疗对坦桑尼亚东北部2型糖尿病患者血糖控制及相关因素的影响:一项回顾性队列研究

Effects of Statin Therapy on Glycemic Control and Associated Factors Among Type 2 Diabetes Mellitus Patients in Northeastern Tanzania: A Retrospective Cohort Study.

作者信息

Mujuni Daniel P, Kilonzo Kajiru G, Sadiq Abid M, Kyala Norman J, Makupa Philip C, Laizer Sweetness N, Mkwizu Elifuraha W, Lyamuya Furaha S, Shao Elichilia R, Mboya Erick A, Chamba Nyasatu G

机构信息

Department of Internal Medicine, KCMC University, Moshi, Tanzania.

Department of Internal Medicine, Kilimanjaro Christian Medical Centre, Moshi, Tanzania.

出版信息

J Diabetes Res. 2025 Aug 1;2025:6626154. doi: 10.1155/jdr/6626154. eCollection 2025.

DOI:10.1155/jdr/6626154
PMID:40785972
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12334290/
Abstract

Statins have been implicated in poor glycemic control among patients with diabetes mellitus (DM), prompting the US Food and Drug Administration (FDA) to update warning labels on all statins to reflect the risk of increased blood glucose levels. However, few studies from sub-Saharan Africa have assessed this concern. This study investigated the effects of statins on glycemic control among patients with Type 2 diabetes mellitus (T2DM) in Kilimanjaro, northeastern Tanzania. This was a hospital-based retrospective cohort study evaluating changes in glycated hemoglobin (HbA) at 1-3, 7-12, and 19-24 months, as the primary outcome, comparing statin users and nonusers among T2DM patients attending DM clinic at Kilimanjaro Christian Medical Centre in Tanzania. Binomial regression models were fitted to calculate adjusted risk ratios for independent predictors of a ≥ 0.2% rise in HbA, with statistical significance set at < 0.05. Out of 122 patients, 51 (41.8%) were on statin therapy. Among these, 46 (90.2%) were prescribed atorvastatin. Statin users had an increase of mean HbA from 10.6% ± 2.7% at baseline compared to 11.6% ± 2.8% at 1-3 months ( = 0.114), followed by a decrease to 10.1% ± 2.2% at 7-12 months ( = 1.0), and 10.0% ± 2.5% at 19-24 months ( = 1.0). However, atorvastatin users ( = 46) had a significant increase of mean HbA from 10.7% ± 2.8% at baseline compared to 11.9% ± 2.7% at 1-3 months ( = 0.04). In contrast, nonstatin users had a consistent and significant decrease in HbA from 11.3% ± 2.8% at baseline compared to 9.7% ± 2.2% at 1-3 months ( = 0.001), to 9.7% ± 2.6% at 7-12 months ( = 0.011), and to 9.3% ± 2.2% at 19-24 months ( = 0.001). Statin therapy among patients with T2DM was associated with short-lived worsening of glycemic control at 1-3 months posttherapy.

摘要

他汀类药物与糖尿病(DM)患者血糖控制不佳有关,这促使美国食品药品监督管理局(FDA)更新了所有他汀类药物的警示标签,以反映血糖水平升高的风险。然而,撒哈拉以南非洲地区很少有研究评估这一问题。本研究调查了他汀类药物对坦桑尼亚东北部乞力马扎罗地区2型糖尿病(T2DM)患者血糖控制的影响。这是一项基于医院的回顾性队列研究,评估糖化血红蛋白(HbA)在1 - 3个月、7 - 12个月和19 - 24个月时的变化作为主要结局,比较在坦桑尼亚乞力马扎罗基督教医疗中心糖尿病诊所就诊的T2DM患者中他汀类药物使用者和非使用者。采用二项回归模型计算HbA升高≥0.2%的独立预测因素的调整风险比,设定统计学显著性为<0.05。在122名患者中,51名(41.8%)接受他汀类药物治疗。其中,46名(90.2%)被处方阿托伐他汀。他汀类药物使用者的平均HbA从基线时的10.6%±2.7%在1 - 3个月时升至11.6%±2.8%(P = 0.114),随后在7 - 12个月时降至10.1%±2.2%(P = 1.0),在19 - 24个月时降至10.0%±2.5%(P = 1.0)。然而,阿托伐他汀使用者(n = 46)的平均HbA从基线时的10.7%±2.8%在1 - 3个月时显著升至11.9%±2.7%(P = 0.04)。相比之下,非他汀类药物使用者的HbA从基线时的11.3%±2.8%在1 - 3个月时持续显著下降至9.7%±2.2%(P = 0.001),在7 - 12个月时降至9.7%±2.6%(P = 0.011),在19 - 24个月时降至9.3%±2.2%(P = 0.001)。T2DM患者使用他汀类药物治疗与治疗后1 - 3个月血糖控制的短期恶化有关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4f7d/12334290/c38fd25ead18/JDR2025-6626154.004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4f7d/12334290/73affdd81c06/JDR2025-6626154.001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4f7d/12334290/476887deff0d/JDR2025-6626154.002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4f7d/12334290/0040f93bec43/JDR2025-6626154.003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4f7d/12334290/c38fd25ead18/JDR2025-6626154.004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4f7d/12334290/73affdd81c06/JDR2025-6626154.001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4f7d/12334290/476887deff0d/JDR2025-6626154.002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4f7d/12334290/0040f93bec43/JDR2025-6626154.003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4f7d/12334290/c38fd25ead18/JDR2025-6626154.004.jpg

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本文引用的文献

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The association between statin use and diabetic nephropathy in US adults: data from NHANES 2005 - 2018.美国成年人中他汀类药物使用与糖尿病肾病的关联:来自 NHANES 2005-2018 年的数据。
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Reduction of Cardiovascular Disease and Mortality Versus Risk of New-Onset Diabetes Mellitus With Statin Use in Patients With Rheumatoid Arthritis.类风湿关节炎患者使用他汀类药物降低心血管疾病和死亡率与新发糖尿病风险的对比
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