Residual risk of cardiovascular complications in statin-using patients with type 2 diabetes: the Taiwan Diabetes Registry Study
Abstract Background The residual risks of atherosclerotic cardiovascular disease in statin-treated patients with diabetes remain unclear. This study was conducted to identify factors associated with these residual risks in patients with no prior vascular event. Methods Data on 683 statin-using patie...
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| Format: | Article |
| Language: | English |
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BMC
2024-01-01
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| Series: | Lipids in Health and Disease |
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| Online Access: | https://doi.org/10.1186/s12944-023-02001-z |
| _version_ | 1797276322921185280 |
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| author | Chin-Sung Kuo Nai-Rong Kuo Yun-Kai Yeh Yau-Jiunn Lee Lee-Ming Chuang Hua-Fen Chen Ching-Chu Chen Chun-Chuan Lee Chih-Cheng Hsu Hung-Yuan Li Horng-Yih Ou Chii-Min Hwu |
| author_facet | Chin-Sung Kuo Nai-Rong Kuo Yun-Kai Yeh Yau-Jiunn Lee Lee-Ming Chuang Hua-Fen Chen Ching-Chu Chen Chun-Chuan Lee Chih-Cheng Hsu Hung-Yuan Li Horng-Yih Ou Chii-Min Hwu |
| author_sort | Chin-Sung Kuo |
| collection | DOAJ |
| description | Abstract Background The residual risks of atherosclerotic cardiovascular disease in statin-treated patients with diabetes remain unclear. This study was conducted to identify factors associated with these residual risks in patients with no prior vascular event. Methods Data on 683 statin-using patients with type 2 diabetes mellitus (T2DM) from the Taiwan Diabetes Registry were used in this study. Patients aged < 25 or > 65 years at the time of diabetes diagnosis and those with diabetes durations ≥ 20 years were excluded. The United Kingdom Prospective Diabetes Study risk engine (version 2.01; https://www.dtu.ox.ac.uk/riskengine/ ) was used to calculate 10-year residual nonfatal and fatal coronary heart disease (CHD) and stroke risks. Associations of these risks with physical and biochemical variables, including medication use and comorbidity, were examined. Results The 10-year risks of nonfatal CHD in oral anti-diabetic drug (OAD), insulin and OAD plus insulin groups were 11.8%, 16.0%, and 16.8%, respectively. The 10-year risks of nonfatal stroke in OAD, insulin and OAD plus insulin groups were 3.0%, 3.4%, and 4.3%, respectively. In the multivariate model, chronic kidney disease (CKD), neuropathy, insulin use, calcium-channel blocker (CCB) use, higher body mass indices (BMI), low-density lipoprotein (LDL), fasting glucose, log-triglyceride (TG), and log–alanine transaminase (ALT) levels were associated with an increased CHD risk. The residual risk of stroke was associated with CKD, neuropathy, CCB use, and lower LDL cholesterol levels, higher BMI and diastolic blood pressure. Conclusion This study indicated that insulin was probably a residual risk factor of CHD but not stroke, and that there was a possible presence of obesity paradox in patients with T2DM on statin therapy. In addition to lowering TG and normalizing fasting glucose levels, lower LDL cholesterol level is better for reduction of risk of CHD on statin therapy. On the other hand, lower LDL cholesterol level could potentially be related to higher risk of stroke among populations receiving statin therapy. These findings suggest potential therapeutic targets for residual cardiovascular risk reduction in patients with T2DM on statin therapy. |
| first_indexed | 2024-03-07T15:26:37Z |
| format | Article |
| id | doaj.art-44e72066d91b43ad87d926f28c67bec1 |
| institution | Directory Open Access Journal |
| issn | 1476-511X |
| language | English |
| last_indexed | 2024-03-07T15:26:37Z |
| publishDate | 2024-01-01 |
| publisher | BMC |
| record_format | Article |
| series | Lipids in Health and Disease |
| spelling | doaj.art-44e72066d91b43ad87d926f28c67bec12024-03-05T16:40:59ZengBMCLipids in Health and Disease1476-511X2024-01-0123111110.1186/s12944-023-02001-zResidual risk of cardiovascular complications in statin-using patients with type 2 diabetes: the Taiwan Diabetes Registry StudyChin-Sung Kuo0Nai-Rong Kuo1Yun-Kai Yeh2Yau-Jiunn Lee3Lee-Ming Chuang4Hua-Fen Chen5Ching-Chu Chen6Chun-Chuan Lee7Chih-Cheng Hsu8Hung-Yuan Li9Horng-Yih Ou10Chii-Min Hwu11Division of Endocrinology and Metabolism, Department of Medicine, Taipei Veterans General HospitalDivision of Endocrinology and Metabolism, Department of Medicine, Taipei Veterans General HospitalDivision of Endocrinology and Metabolism, Department of Medicine, Taipei Veterans General HospitalDepartment of Internal Medicine, Lee’s Endocrinology ClinicDivision of Endocrinology & Metabolism, Department of Internal Medicine, National Taiwan University HospitalSection of Endocrinology and Metabolism, Department of Internal Medicine, Far Eastern Memorial HospitalDivision of Endocrinology and Metabolism, Department of Medicine, China Medical University HospitalDivision of Endocrinology and Metabolism, Department of Internal Medicine, MacKay Memorial HospitalInstitute of Population Health Sciences, National Health Research InstitutesDivision of Endocrinology and Metabolism, Department of Internal Medicine, National Taiwan University HospitalDivision of Endocrinology and Metabolism, Department of Internal Medicine, National Cheng Kung University HospitalDivision of Endocrinology and Metabolism, Department of Medicine, Taipei Veterans General HospitalAbstract Background The residual risks of atherosclerotic cardiovascular disease in statin-treated patients with diabetes remain unclear. This study was conducted to identify factors associated with these residual risks in patients with no prior vascular event. Methods Data on 683 statin-using patients with type 2 diabetes mellitus (T2DM) from the Taiwan Diabetes Registry were used in this study. Patients aged < 25 or > 65 years at the time of diabetes diagnosis and those with diabetes durations ≥ 20 years were excluded. The United Kingdom Prospective Diabetes Study risk engine (version 2.01; https://www.dtu.ox.ac.uk/riskengine/ ) was used to calculate 10-year residual nonfatal and fatal coronary heart disease (CHD) and stroke risks. Associations of these risks with physical and biochemical variables, including medication use and comorbidity, were examined. Results The 10-year risks of nonfatal CHD in oral anti-diabetic drug (OAD), insulin and OAD plus insulin groups were 11.8%, 16.0%, and 16.8%, respectively. The 10-year risks of nonfatal stroke in OAD, insulin and OAD plus insulin groups were 3.0%, 3.4%, and 4.3%, respectively. In the multivariate model, chronic kidney disease (CKD), neuropathy, insulin use, calcium-channel blocker (CCB) use, higher body mass indices (BMI), low-density lipoprotein (LDL), fasting glucose, log-triglyceride (TG), and log–alanine transaminase (ALT) levels were associated with an increased CHD risk. The residual risk of stroke was associated with CKD, neuropathy, CCB use, and lower LDL cholesterol levels, higher BMI and diastolic blood pressure. Conclusion This study indicated that insulin was probably a residual risk factor of CHD but not stroke, and that there was a possible presence of obesity paradox in patients with T2DM on statin therapy. In addition to lowering TG and normalizing fasting glucose levels, lower LDL cholesterol level is better for reduction of risk of CHD on statin therapy. On the other hand, lower LDL cholesterol level could potentially be related to higher risk of stroke among populations receiving statin therapy. These findings suggest potential therapeutic targets for residual cardiovascular risk reduction in patients with T2DM on statin therapy.https://doi.org/10.1186/s12944-023-02001-zDiabetesResidual riskStatin |
| spellingShingle | Chin-Sung Kuo Nai-Rong Kuo Yun-Kai Yeh Yau-Jiunn Lee Lee-Ming Chuang Hua-Fen Chen Ching-Chu Chen Chun-Chuan Lee Chih-Cheng Hsu Hung-Yuan Li Horng-Yih Ou Chii-Min Hwu Residual risk of cardiovascular complications in statin-using patients with type 2 diabetes: the Taiwan Diabetes Registry Study Lipids in Health and Disease Diabetes Residual risk Statin |
| title | Residual risk of cardiovascular complications in statin-using patients with type 2 diabetes: the Taiwan Diabetes Registry Study |
| title_full | Residual risk of cardiovascular complications in statin-using patients with type 2 diabetes: the Taiwan Diabetes Registry Study |
| title_fullStr | Residual risk of cardiovascular complications in statin-using patients with type 2 diabetes: the Taiwan Diabetes Registry Study |
| title_full_unstemmed | Residual risk of cardiovascular complications in statin-using patients with type 2 diabetes: the Taiwan Diabetes Registry Study |
| title_short | Residual risk of cardiovascular complications in statin-using patients with type 2 diabetes: the Taiwan Diabetes Registry Study |
| title_sort | residual risk of cardiovascular complications in statin using patients with type 2 diabetes the taiwan diabetes registry study |
| topic | Diabetes Residual risk Statin |
| url | https://doi.org/10.1186/s12944-023-02001-z |
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