Effect of SGLT2 Inhibitors on Diabetes Progression in Statin-Treated Patients: A Population-Based Cohort Study.

IF 3.4 2区医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Clinical Epidemiology Pub Date : 2025-04-21 eCollection Date: 2025-01-01 DOI:10.2147/CLEP.S505242

Jack Ssu-Chi Cheng, Fang-Ju Lin, Chih-Min Fu, Shin-Yi Lin, Chih-Yuan Wang, Hsin-Yi Huang, Chi-Chuan Wang

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引用次数: 0

Abstract

Background: Statins, though widely used, may accelerate diabetes progression, necessitating interventions to counteract this effect.

Purpose: To compare the effect of sodium-glucose co-transporter 2 inhibitors (SGLT2is) and sulfonylureas or meglitinides on diabetes progression in individuals receiving statins.

Patients and methods: This retrospective cohort study utilized data from the National Health Insurance Research Database of Taiwan. We included patients with diabetes receiving statins and newly initiated SGLT2is or sulfonylureas/meglitinides between July 1, 2016 and December 31, 2020. Diabetes progression was defined as insulin initiation, increase in antidiabetic medication class, or occurrence of new acute hyperglycemic complications. Propensity score matching was used to adjust baseline characteristics. Cox proportional hazards regression was used to calculate the hazard ratios for diabetes progression between users of SGLT2is and those of sulfonylureas or meglitinides. The statistical significance level was set at 0.05 for all analyses.

Results: SGLT2i users had a significantly lower risk of diabetes progression compared to sulfonylurea/meglitinide users (HR: 0.53, 95% CI: 0.50-0.57, p-value < 0.001). Similar results were found in insulin initiation (HR: 0.48, 95% CI: 0.38-0.61, p-value < 0.001) and increase in antidiabetic medication class (HR: 0.53, 95% CI: 0.50-0.57, p-value < 0.17). However, the risk of new acute glycemic complications did not significantly differ between groups (HR: 2.47, 95% CI: 0.67-9.08, p-value = 0.17).

Conclusion: SGLT2is may be an effective second-line therapy for statin-treated patients by slowing diabetes progression and potentially mitigating statin-induced metabolic disturbances. Further research, including randomized controlled trials or observational studies with comprehensive laboratory data, is needed to confirm these findings and evaluate their broader applicability.

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SGLT2抑制剂对他汀治疗患者糖尿病进展的影响：一项基于人群的队列研究

背景：他汀类药物虽然被广泛使用，但可能会加速糖尿病的进展，需要干预来抵消这种影响。目的：比较钠-葡萄糖共转运蛋白2抑制剂（SGLT2is）和磺脲类药物或美格列汀类药物对接受他汀类药物治疗的糖尿病进展的影响。患者与方法：本研究采用台湾健保研究数据库资料进行回顾性队列研究。我们纳入了2016年7月1日至2020年12月31日期间接受他汀类药物和新启动的SGLT2is或磺脲类/美格列汀类药物治疗的糖尿病患者。糖尿病进展定义为胰岛素起始，抗糖尿病药物类别增加，或出现新的急性高血糖并发症。倾向评分匹配用于调整基线特征。采用Cox比例风险回归计算SGLT2is使用者与磺脲类或美格列酮类使用者之间糖尿病进展的风险比。所有分析的统计学显著性水平设为0.05。结果：与磺脲/美格列酮使用者相比，SGLT2i使用者的糖尿病进展风险显著降低（HR: 0.53, 95% CI: 0.50-0.57， p值< 0.001）。胰岛素起始（HR: 0.48, 95% CI: 0.38-0.61， p值< 0.001）和抗糖尿病药物类别的增加（HR: 0.53, 95% CI: 0.50-0.57， p值< 0.17）也发现了类似的结果。然而，两组间新发急性血糖并发症的风险无显著差异（HR: 2.47, 95% CI: 0.67-9.08， p值= 0.17）。结论：SGLT2is可能是他汀类药物治疗患者的一种有效的二线治疗方法，可以减缓糖尿病的进展，并有可能减轻他汀类药物引起的代谢紊乱。需要进一步的研究，包括随机对照试验或具有综合实验室数据的观察性研究，来证实这些发现并评估其更广泛的适用性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical Epidemiology Medicine-Epidemiology

CiteScore

6.30

自引率

5.10%

发文量

169

审稿时长

16 weeks

期刊介绍： Clinical Epidemiology is an international, peer reviewed, open access journal. Clinical Epidemiology focuses on the application of epidemiological principles and questions relating to patients and clinical care in terms of prevention, diagnosis, prognosis, and treatment. Clinical Epidemiology welcomes papers covering these topics in form of original research and systematic reviews. Clinical Epidemiology has a special interest in international electronic medical patient records and other routine health care data, especially as applied to safety of medical interventions, clinical utility of diagnostic procedures, understanding short- and long-term clinical course of diseases, clinical epidemiological and biostatistical methods, and systematic reviews. When considering submission of a paper utilizing publicly-available data, authors should ensure that such studies add significantly to the body of knowledge and that they use appropriate validated methods for identifying health outcomes. The journal has launched special series describing existing data sources for clinical epidemiology, international health care systems and validation studies of algorithms based on databases and registries.