Statins and Type 1 Diabetes: Impact on Cardiovascular Outcomes and surrogates. Systematic Review and meta-analysis.

IF 6.4 2区 医学 Q1 ENDOCRINOLOGY & METABOLISM
Karen Feriz-Bonelo, Pablo Corral, María Bernarda Iriarte-Durán, Claudia Gómez-Giraldo, Natalia Nardelli, Oriana Arias Valderrama, María Camila Gómez-Ayala
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Abstract

Purpose of review: Atherosclerotic cardiovascular disease (ASCVD) is the leading cause of death in patients living with type 1 diabetes (T1D). Dyslipidemia is a frequent risk factor in this population. Although statin therapy has demonstrated cardiovascular (CV) benefits in diabetes overall, specific evidence in T1D remains limited. This systematic review aims to evaluate the impact of statins on clinical and surrogate atherosclerosis-related outcomes in patients with T1D without established ASCVD.

Recent findings: Statin use was associated with a significant reduction in the risk of major adverse cardiovascular events (MACE), with a pooled hazard ratio (HR) of 0.77 (95% CI: 0.70-0.84; low certainty), and a mean low-density lipoprotein cholesterol (LDL-C) reduction of 30.3 mg/dL (95% CI: -47.02 to -13.58; moderate certainty). Reductions in ApoB and non-HDL cholesterol were also reported. We conducted a systematic review following PRISMA guidelines. Searches were performed in PubMed, EMBASE, and Epistemonikos from inception to June 2025 using terms related to T1D, statins, and primary prevention. Eleven studies were included-nine randomized controlled trials (RCTs) and two cohort studies. Six (four RCTs and two cohorts) were eligible for meta-analysis of two primary outcomes; the remaining were summarized narratively. Statin use in T1D patients without ASCVD was associated with improved lipid profiles and reduced MACE. These findings support considering statins as a preventive strategy in this population, although prospective studies with hard outcomes are needed to better identify patients most likely to benefit.

他汀类药物和1型糖尿病:对心血管结局的影响和替代品。系统评价和荟萃分析。
综述目的:动脉粥样硬化性心血管疾病(ASCVD)是1型糖尿病(T1D)患者死亡的主要原因。血脂异常是这一人群中常见的危险因素。尽管他汀类药物治疗已证明心血管(CV)对糖尿病的总体益处,但T1D的具体证据仍然有限。本系统综述旨在评估他汀类药物对无ASCVD的T1D患者的临床和替代动脉粥样硬化相关结局的影响。最近发现:他汀类药物的使用与主要不良心血管事件(MACE)风险的显著降低相关,合并风险比(HR)为0.77 (95% CI: 0.70-0.84;低确定性),平均低密度脂蛋白胆固醇(LDL-C)降低30.3 mg/dL (95% CI: -47.02 - -13.58;中等确定性)。载脂蛋白ob和非高密度脂蛋白胆固醇的降低也有报道。我们按照PRISMA指南进行了系统审查。在PubMed, EMBASE和Epistemonikos中进行检索,从成立到2025年6月,使用与T1D,他汀类药物和一级预防相关的术语。纳入了11项研究,包括9项随机对照试验(rct)和2项队列研究。6个(4个随机对照试验和2个队列)符合两个主要结局的荟萃分析;其余的则以叙述的方式加以总结。无ASCVD的T1D患者使用他汀类药物可改善血脂和降低MACE。这些发现支持考虑将他汀类药物作为这一人群的预防策略,尽管需要有明确结果的前瞻性研究来更好地确定最有可能受益的患者。
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来源期刊
CiteScore
9.80
自引率
0.00%
发文量
52
审稿时长
6-12 weeks
期刊介绍: The goal of this journal is to publish cutting-edge reviews on subjects pertinent to all aspects of diabetes epidemiology, pathophysiology, and management. We aim to provide incisive, insightful, and balanced contributions from leading experts in each relevant domain that will be of immediate interest to a wide readership of clinicians, basic scientists, and translational investigators. We accomplish this aim by appointing major authorities to serve as Section Editors in key subject areas across the discipline. Section Editors select topics to be reviewed by leading experts who emphasize recent developments and highlight important papers published over the past year on their topics, in a crisp and readable format. We also provide commentaries from well-known figures in the field, and an Editorial Board of internationally diverse members suggests topics of special interest to their country/region and ensures that topics are current and include emerging research.
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