PMID- 38263010 OWN - NLM STAT- MEDLINE DCOM- 20240125 LR - 20240202 IS - 1476-511X (Electronic) IS - 1476-511X (Linking) VI - 23 IP - 1 DP - 2024 Jan 23 TI - Residual risk of cardiovascular complications in statin-using patients with type 2 diabetes: the Taiwan Diabetes Registry Study. PG - 24 LID - 10.1186/s12944-023-02001-z [doi] LID - 24 AB - 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. CI - (c) 2024. The Author(s). FAU - Kuo, Chin-Sung AU - Kuo CS AD - Division of Endocrinology and Metabolism, Department of Medicine, Taipei Veterans General Hospital, 112, No. 201, Sec. 2, Shih-Pai Road, Taipei, Taiwan. AD - School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan. FAU - Kuo, Nai-Rong AU - Kuo NR AD - Division of Endocrinology and Metabolism, Department of Medicine, Taipei Veterans General Hospital, 112, No. 201, Sec. 2, Shih-Pai Road, Taipei, Taiwan. AD - School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan. FAU - Yeh, Yun-Kai AU - Yeh YK AD - Division of Endocrinology and Metabolism, Department of Medicine, Taipei Veterans General Hospital, 112, No. 201, Sec. 2, Shih-Pai Road, Taipei, Taiwan. AD - School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan. FAU - Lee, Yau-Jiunn AU - Lee YJ AD - Department of Internal Medicine, Lee's Endocrinology Clinic, Pingtung, Taiwan. FAU - Chuang, Lee-Ming AU - Chuang LM AD - Division of Endocrinology & Metabolism, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan, ROC. FAU - Chen, Hua-Fen AU - Chen HF AD - Section of Endocrinology and Metabolism, Department of Internal Medicine, Far Eastern Memorial Hospital, New Taipei City, Taiwan. FAU - Chen, Ching-Chu AU - Chen CC AD - Division of Endocrinology and Metabolism, Department of Medicine, China Medical University Hospital, Taichung, Taiwan. FAU - Lee, Chun-Chuan AU - Lee CC AD - Division of Endocrinology and Metabolism, Department of Internal Medicine, MacKay Memorial Hospital, Taipei, Taiwan. AD - Department of Medicine, MacKay Medical College, New Taipei City, Taiwan. FAU - Hsu, Chih-Cheng AU - Hsu CC AD - Institute of Population Health Sciences, National Health Research Institutes, Zhunan, Miaoli, Taiwan. FAU - Li, Hung-Yuan AU - Li HY AD - Division of Endocrinology and Metabolism, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan. FAU - Ou, Horng-Yih AU - Ou HY AD - Division of Endocrinology and Metabolism, Department of Internal Medicine, National Cheng Kung University Hospital, Tainan, Taiwan. wahoryi@mail.ncku.edu.tw. AD - College of Medicine, National Cheng Kung University, Tainan, Taiwan. wahoryi@mail.ncku.edu.tw. FAU - Hwu, Chii-Min AU - Hwu CM AD - Division of Endocrinology and Metabolism, Department of Medicine, Taipei Veterans General Hospital, 112, No. 201, Sec. 2, Shih-Pai Road, Taipei, Taiwan. chhwu@vghtpe.gov.tw. AD - School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan. chhwu@vghtpe.gov.tw. LA - eng GR - V110C-165, V111C-190/Taipei Veterans General Hospital/ GR - V110C-175, V111C-188, V112C-164/Taipei Veterans General Hospital/ GR - MOST 110-2314-B-075-027-MY3/National Science and Technology Council/ PT - Journal Article DEP - 20240123 PL - England TA - Lipids Health Dis JT - Lipids in health and disease JID - 101147696 RN - 0 (Hydroxymethylglutaryl-CoA Reductase Inhibitors) RN - 0 (Cholesterol, LDL) RN - 0 (Insulin) RN - 0 (Calcium Channel Blockers) RN - IY9XDZ35W2 (Glucose) SB - IM MH - Humans MH - *Diabetes Mellitus, Type 2 MH - *Hydroxymethylglutaryl-CoA Reductase Inhibitors MH - Cholesterol, LDL MH - Prospective Studies MH - Taiwan MH - Insulin MH - *Stroke MH - Calcium Channel Blockers MH - Glucose MH - *Renal Insufficiency, Chronic PMC - PMC10804647 OTO - NOTNLM OT - Diabetes OT - Residual risk OT - Statin COIS- The authors declare no competing interests. EDAT- 2024/01/24 00:42 MHDA- 2024/01/25 06:43 PMCR- 2024/01/23 CRDT- 2024/01/23 23:36 PHST- 2023/11/05 00:00 [received] PHST- 2023/12/31 00:00 [accepted] PHST- 2024/01/25 06:43 [medline] PHST- 2024/01/24 00:42 [pubmed] PHST- 2024/01/23 23:36 [entrez] PHST- 2024/01/23 00:00 [pmc-release] AID - 10.1186/s12944-023-02001-z [pii] AID - 2001 [pii] AID - 10.1186/s12944-023-02001-z [doi] PST - epublish SO - Lipids Health Dis. 2024 Jan 23;23(1):24. doi: 10.1186/s12944-023-02001-z.