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Zhang X, Li SY, Jing J, Pan YS, Yan HY, Meng X, Zhao XQ, Liu LP, Wang CX, Wang YL, Wang YJ. Inpatient statin use and stroke recurrence in patients with or without diabetes mellitus. Neurol Res 2019; 41:893-899. [PMID: 31328681 DOI: 10.1080/01616412.2019.1642436] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Objectives: Although statin therapy is associated with lower recurrence in patients with acute ischaemic stroke, data-evaluating associations between inpatient statin use and stroke recurrence in diabetic patients after acute stroke onset are limited. Methods: This study was based on population data from the Chinese National Stroke Registry. Patients with acute ischaemic stroke and no history of statin therapy were selected. Individuals treated regularly with any type or dosage of statins during acute hospitalization were defined as having inpatient statin therapy. The subjects were divided into two groups according to statin use status during acute hospitalization. Multivariate logistic regression analysis was used to analyse the associations between statin use and stroke recurrence in patients with or without diabetes. Results: A total of 11,429 patients, 2341 (20.48%) with diabetes, were selected for analysis. Statin therapy during hospitalization was documented in 4982 (43.59%). Logistic analysis showed no significant associations between inpatient statin use and stroke recurrence in diabetic subjects at 3 months (OR = 0.90, 95% CI = 0.69-1.16, P = 0.40) or 1 year (OR = 0.92, 95% CI = 0.74-1.16, P = 0.48), but statin use was significantly associated with lower recurrence in non-diabetic patients at both 3 months (OR = 0.80, 95% CI = 0.69-0.92, P = 0.002) and 1 year (OR = 0.82, 95% CI = 0.72-0.93, P = 0.002) after discharge. Conclusion: Inpatient statin use was associated with lower stroke recurrence in non-diabetic patients after acute ischaemic stroke, but no definite association between inpatient statin use and stroke recurrence in patients with diabetes mellitus was found.
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Affiliation(s)
- Xing Zhang
- Department of Neurology, Beijing Tiantan hospital, Capital Medical University , Beijing , China.,China National Clinical Research Centre for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University , Beijing , China.,Beijing Key laboratory of Translational Medicine for Cerebrovascular Disease, Gurukula Kangri Vishwavidyalaya , Beijing , China.,Center of Stroke, Beijing Institute for Brain Disorders , Beijing , Chin
| | - Shu-Ya Li
- Department of Neurology, Beijing Tiantan hospital, Capital Medical University , Beijing , China.,China National Clinical Research Centre for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University , Beijing , China.,Beijing Key laboratory of Translational Medicine for Cerebrovascular Disease, Gurukula Kangri Vishwavidyalaya , Beijing , China.,Center of Stroke, Beijing Institute for Brain Disorders , Beijing , Chin
| | - Jing Jing
- Department of Neurology, Beijing Tiantan hospital, Capital Medical University , Beijing , China.,China National Clinical Research Centre for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University , Beijing , China.,Beijing Key laboratory of Translational Medicine for Cerebrovascular Disease, Gurukula Kangri Vishwavidyalaya , Beijing , China.,Center of Stroke, Beijing Institute for Brain Disorders , Beijing , Chin
| | - Yue-Song Pan
- Department of Neurology, Beijing Tiantan hospital, Capital Medical University , Beijing , China.,China National Clinical Research Centre for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University , Beijing , China.,Beijing Key laboratory of Translational Medicine for Cerebrovascular Disease, Gurukula Kangri Vishwavidyalaya , Beijing , China.,Center of Stroke, Beijing Institute for Brain Disorders , Beijing , Chin
| | - Hong-Yi Yan
- Department of Neurology, Beijing Tiantan hospital, Capital Medical University , Beijing , China.,China National Clinical Research Centre for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University , Beijing , China.,Beijing Key laboratory of Translational Medicine for Cerebrovascular Disease, Gurukula Kangri Vishwavidyalaya , Beijing , China.,Center of Stroke, Beijing Institute for Brain Disorders , Beijing , Chin
| | - Xia Meng
- Department of Neurology, Beijing Tiantan hospital, Capital Medical University , Beijing , China.,China National Clinical Research Centre for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University , Beijing , China.,Beijing Key laboratory of Translational Medicine for Cerebrovascular Disease, Gurukula Kangri Vishwavidyalaya , Beijing , China.,Center of Stroke, Beijing Institute for Brain Disorders , Beijing , Chin
| | - Xing-Quan Zhao
- Department of Neurology, Beijing Tiantan hospital, Capital Medical University , Beijing , China.,China National Clinical Research Centre for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University , Beijing , China.,Beijing Key laboratory of Translational Medicine for Cerebrovascular Disease, Gurukula Kangri Vishwavidyalaya , Beijing , China.,Center of Stroke, Beijing Institute for Brain Disorders , Beijing , Chin
| | - Li-Ping Liu
- Department of Neurology, Beijing Tiantan hospital, Capital Medical University , Beijing , China.,China National Clinical Research Centre for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University , Beijing , China.,Beijing Key laboratory of Translational Medicine for Cerebrovascular Disease, Gurukula Kangri Vishwavidyalaya , Beijing , China.,Center of Stroke, Beijing Institute for Brain Disorders , Beijing , Chin
| | - Chun-Xue Wang
- Department of Neurology, Beijing Tiantan hospital, Capital Medical University , Beijing , China.,China National Clinical Research Centre for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University , Beijing , China.,Beijing Key laboratory of Translational Medicine for Cerebrovascular Disease, Gurukula Kangri Vishwavidyalaya , Beijing , China.,Center of Stroke, Beijing Institute for Brain Disorders , Beijing , Chin
| | - Yi-Long Wang
- Department of Neurology, Beijing Tiantan hospital, Capital Medical University , Beijing , China.,China National Clinical Research Centre for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University , Beijing , China.,Beijing Key laboratory of Translational Medicine for Cerebrovascular Disease, Gurukula Kangri Vishwavidyalaya , Beijing , China.,Center of Stroke, Beijing Institute for Brain Disorders , Beijing , Chin
| | - Yong-Jun Wang
- Department of Neurology, Beijing Tiantan hospital, Capital Medical University , Beijing , China.,China National Clinical Research Centre for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University , Beijing , China.,Beijing Key laboratory of Translational Medicine for Cerebrovascular Disease, Gurukula Kangri Vishwavidyalaya , Beijing , China.,Center of Stroke, Beijing Institute for Brain Disorders , Beijing , Chin
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Kim J, Lee HS, Lee KY. Effect of statins on fasting glucose in non-diabetic individuals: nationwide population-based health examination in Korea. Cardiovasc Diabetol 2018; 17:155. [PMID: 30518364 PMCID: PMC6280428 DOI: 10.1186/s12933-018-0799-4] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2018] [Accepted: 12/01/2018] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Increasing evidence suggest that statin therapy has a diabetogenic effect. Individual types of statin may have a different effect on glucose metabolism. Using the repeated nationwide population-based health screening data in Korea, we investigated the longitudinal changes in fasting glucose level of non-diabetic individuals by use of statins. METHODS From the National Health Screening Cohort, we included 379,865 non-diabetic individuals who had ≥ 2 health screening examinations with fasting blood glucose level measured in 2002-2013. Using the prescription records of statins in the database, we calculated the proportion of days covered (PDC) and average number of defined daily doses per day (anDDD) by statins. We constructed multivariate linear mixed models to evaluate the effects of statins on the changes in fasting glucose (Δglu). RESULTS High PDC by statins had a significant positive effect on Δglu (coefficient for PDC 0.093 mmol/L, standard error 0.007, p < 0.001). anDDD by statins was also positively associated with Δglu (coefficient for anDDD 0.119 mmol/L, standard error 0.009, p < 0.001). Unlike statins, the PDC by fibrate and ezetimibe were not significantly associated with Δglu. There was no significant interaction effect on Δglu between time interval and statin. Considering individual types of statins, use of atorvastatin, rosuvastatin, pitavastatin, and simvastatin were significantly associated with increase of Δglu. Pravastatin, lovastatin, and fluvastatin were also positively associated with Δglu, but were not statistically significant. CONCLUSIONS More adherent and intensive use of statins was significantly associated with an increase in fasting glucose of non-diabetic individuals. In subgroup analysis of individual statins, use of atorvastatin, rosuvastatin, pitavastatin and simvastatin had significant association with increase in fasting glucose. Pravastatin, lovastatin, and fluvastatin had non-significant trend toward an increased fasting glucose. Our findings suggest the medication class effect of statins inducing hyperglycemia.
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Affiliation(s)
- Jinkwon Kim
- Department of Neurology, CHA Bundang Medical Center, CHA University College of Medicine, Seongnam, Republic of Korea
| | - Hye Sun Lee
- Biostatistics Collaboration Unit, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Kyung-Yul Lee
- Department of Neurology, Gangnam Severance Hospital, Yonsei University College of Medicine, 211 Eonju-ro, Gangnam-gu, Seoul, 06273, Republic of Korea.
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