Persistent lipid abnormalities in statin‐treated patients with diabetes mellitus in Europe and Canada: results of the Dyslipidaemia International Study

Abstract

Aim To assess the prevalence of persistent lipid abnormalities in statin-treated patients with diabetes with and without the metabolic syndrome.Methods This was a cross-sectional study of 22 063 statin-treated outpatients consecutively recruited by clinicians in Canada and 11 European countries. Patient cardiovascular risk factors, risk level, lipid measurements and lipid-modifying medication regimens were recorded.Results Of the 20 129 subjects who had documented diabetes and ⁄ or metabolic syndrome status, 41% had diabetes (of whom 86.8% also had the metabolic syndrome). Of those with diabetes, 48.1% were not at total cholesterol target compared with 58% of those without diabetes. Amongst those with diabetes, 41.6 and 41.3% of those with and without the metabolic syndrome, respectively, were not at their LDL cholesterol goal relative to 54.2% of those with metabolic syndrome and without diabetes, and 52% of those with neither condition. Twenty per cent of people with diabetes but without the metabolic syndrome were not at the optimal HDL cholesterol level compared with 9% of those with neither condition. Of people with diabetes and the metabolic syndrome, 49.9% were not at optimal triglyceride level relative to 13.5% of people with neither diabetes nor the metabolic syndrome. Simvastatin was the most commonly prescribed statin (> 45%) and the most common statin potency was 20-40 mg ⁄ day (simvastatin equivalent). Approximately 14% of patients were taking ezetimibe alone or in combination with a statin.Conclusions Despite evidence supporting the benefits of lipid modification and international guideline recommendations, statin-treated patients with diabetes had a high prevalence of persistent lipid abnormalities. There is frequently room to optimize therapy through statin dose up-titration and ⁄ or addition of other lipid-modifying therapies.

Lipid Profili, Serum Ürik Asit, Glukoz ve İnsülin Direnci Üzerine Gilbert"s Sendromunun Etkileri

“…Low insulin resistance levels in GS patients may indicate a protective effect against atherosclerotic heart disease. Additionally, persistent hyperinsulinemia not only increases serum levels of TG and LDL but also decreases serum levels of HDL 28 . That explains why we found low levels of TG and LDL is addition to high HDL levels in GS patients.…”

Dyslipidemia aterogenna w codziennej praktyce — interdyscyplinarny konsensus polskich ekspertów

“…Czą-steczki LDL-C są w tym przypadku mniejsze, charakteryzują je większa gęstość i większy potencjał aterogenności między innymi ze względu na zwiększoną zawartość apolipoproteiny B (apo B). W europejsko-kanadyjskim rejestrze Dyslipidemia International Study, obejmującym 22 063 osób leczonych w warunkach ambulatoryjnych statyną, wykazano, że w obserwowanej grupie występowało podwyższone stężenie TG i/lub obniżone stężenie HDL-C [3]. W polskiej populacji stężenie HDL-C poniżej 40 mg/dl obserwuje się u 35% mężczyzn, a mniejsze niż 50 mg/dl u 38% kobiet.…”

Diabeteses dyslipidaemia és atherosclerosis

“…Statinnal kezelt T2DM-betegekben a közelmúltban 35-50%-os gyakoriságúnak találták a dyslipidaemiát [9,10].…”