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Prevalence and factors associated with statin use in high-risk patients with type 1 diabetes from a specialized
Antonio J Amor1, Emilio Ortega1, Marga Giménez2
1Endocrinology and Nutrition Department, Institut d'Investigacions Biomèdiques August Pi Sunyer (IDIBAPS), Hospital Clínic, Barcelona, Spain; Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain.
Insights
Statin use for cardiovascular disease prevention in type 1 diabetes (T1D) is low. Only hypertension and BMI were independently linked to statin therapy in T1D patients meeting treatment criteria.
Area of Science:
- Cardiology
- Endocrinology
- Public Health
Background:
- Statin use is low in type 1 diabetes (T1D) populations.
- Cardiovascular disease (CVD) is a major risk for T1D patients.
- Primary prevention of CVD in T1D requires careful risk assessment.
Purpose of the Study:
- To determine the prevalence of statin treatment in T1D patients eligible for primary CVD prevention.
- To identify factors associated with statin use in this high-risk group.
Main Methods:
- A cohort of 241 T1D patients from a tertiary hospital (2015-2018) was analyzed.
- Inclusion criteria: age ≥40, diabetic nephropathy, or T1D duration ≥10 years with ≥1 cardiovascular risk factor (CVRF).
- Multivariable regression models assessed determinants of statin use.
Main Results:
- 43% of eligible T1D patients were on statins; 27% had LDL-cholesterol <100 mg/dL.
- Statin users had higher BMI, hypertension, and kidney dysfunction.
- Hypertension (OR, 2.96) and BMI (OR, 1.08) were independently associated with statin use.
Conclusions:
- Less than half of T1D patients meeting criteria received statin therapy for CVD prevention.
- Hypertension and BMI were the only independent predictors of statin use.
- Improved strategies are essential for CVD risk management in T1D.
Introduction:
The use of statins in non-selected type 1 diabetes (T1D) populations is low. We assessed the prevalence and factors associated with statin treatment in patients meeting criteria for this therapy for primary prevention of cardiovascular disease (CVD).
Material And Methods:
From 2015 to 2018, T1D patients from a tertiary hospital were selected. Inclusion criteria were: ≥40 years-old, diabetic nephropathy, or T1D duration ≥10 years with ≥1 cardiovascular risk factor (CVRF). A standardized cardiovascular risk evaluation protocol was performed. Prevalence of statin treatment was evaluated according to presence of several CVRFs, and multivariable models were constructed to assess independent determinants of statin use.
Results:
We included 241 patients (50% women, age 48.2±9.9 years, T1D duration 26.6±9.0 years). Diabetic retinopathy and nephropathy, active smoking, and hypertension were present in 38%, 12%, 28%, and 27%, respectively. Overall, 43% of patients were on statins and 27% had LDL-cholesterol <100mg/dl. Statin users were older, and had higher body mass index (BMI), prevalence of kidney dysfunction, and hypertension (p<0.05 for all). However, among both T1D-related and classical CVRFs, only hypertension (odds ratio [OR], 2.96; 95% confidence interval [CI] 1.48-5.91) and BMI (OR, 1.08; CI, 1.01-1.16) were independently associated with statin use in multiple regression analysis.
Conclusions:
Less than half of T1D patients from a tertiary hospital who met criteria for statin use were on treatment. Hypertension and BMI emerged as the only CVRFs independently associated with statin therapy. New strategies are needed to better address CVD prevention in this very high-risk population.
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