The Long-Term Effect of Statins on the Risk of New-Onset Diabetes Mellitus in Elderly Taiwanese Patients with Hypertension and Dyslipidaemia A Retrospective Longitudinal Cohort Study
The Long-Term Effect of Statins on the Risk of New-Onset Diabetes Mellitus in Elderly Taiwanese Patients with Hypertension and Dyslipidaemia A Retrospective Longitudinal Cohort Study
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DOI：
10.2165/11597250-000000000-00000
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发表时间：
2012-01-01
期刊：
影响因子：
2.8
通讯作者：
Jong, Gwo-Ping
中科院分区：
文献类型：
--
作者：
Ma, Tsochiang;Chang, Mu-Hsin;Jong, Gwo-Ping
背景：HMG-CoA还原酶抑制剂（他汀类药物）与新发糖尿病（NOD）有关。不同的他汀类药物增加NOD风险的程度可能不同，但是，他汀类药物对老年高血压和血脂异常患者NOD发生的影响还没有得到很好的研究。目的：本研究的目的是调查老年人NOD的相对风险（年龄>=.65岁）接受不同他汀类药物治疗的高血压和血脂异常的台湾患者。这是一项回顾性队列研究，使用2004年7月至2009年12月提供给台湾全民健康保险局中央地区分支的索赔表数据进行。从处方数据库中检索索引日期之前的他汀类药物处方。我们估计了与他汀类药物使用相关的NOD的风险比（HR）。结果：在15637例老年高血压合并血脂异常患者中，共发现2735例NOD患者。调整性别、年龄、合并用药和平均处方剂量后，阿托伐他汀（HR 0.77; 95% CI 0.71，0.83）和瑞舒伐他汀（HR 0.65; 95% CI 0.51，0.82）使用者的NOD风险低于非使用者。服用洛伐他汀（HR 1.38; 95% CI 1.26，1.50）或辛伐他汀（HR 1.30; 95% CI 1.14，1.48）的患者比非使用者发生NOD的风险更高。普伐他汀和氟伐他汀与NOD.Conclusions的风险增加无关：本研究的结果表明，老年高血压和血脂异常患者服用阿托伐他汀或瑞舒伐他汀的NOD的风险较低。洛伐他汀和辛伐他汀与NOD风险显著增加相关。
Background: HMG-CoA reductase inhibitors (statins) have been linked to new-onset diabetes (NOD). Individual statins may differ in the extent to which they increase the risk for NOD; however, the effect of statins on the development of NOD in elderly hypertensive and dyslipidaemic patients has not been well studied.Objective: The aim of this study was to investigate the relative risk for NOD among elderly (age >=.65 years) hypertensive and dyslipidaemic Taiwanese patients who received different statins.Methods: This was a retrospective cohort study performed using data from claim forms provided to the central regional branch of the Bureau of National Health Insurance in Taiwan from July 2004 to December 2009. Prescriptions for statins before the index date were retrieved from a prescription database. We estimated the hazard ratios (HRs) of NOD associated with statin use. Non-diabetic subjects served as the reference group.Results: A total of 2735 NOD cases were identified among 15 637 elderly hypertensive and dyslipidaemic patients during the study period. The risk of NOD after adjusting for sex, age, concomitant medication and mean dose of prescription was lower among users of atorvastatin (HR 0.77; 95% CI 0.71, 0.83) and rosuvastatin (HR 0.65; 95% CI 0.51, 0.82) than among non-users. Patients who took lovastatin (HR 1.38; 95% CI 1.26, 1.50) or simvastatin (HR 1.30; 95% CI 1.14, 1.48) were at higher risk of developing NOD than non-users. Pravastatin and fluvastatin were not associated with increased risk of NOD.Conclusions: The results of this study suggest that elderly hypertensive and dyslipidaemic patients who take atorvastatin or rosuvastatin are at lower risk of NOD. Lovastatin and simvastatin were associated with a significant increase in the risk of NOD.