Statin Therapy and Risk of Polyneuropathy in Type 2 Diabetes: A Danish Cohort Study.

Abstract:

OBJECTIVE:Statins may reduce the risk of diabetic polyneuropathy (DPN) as a result of lipid-lowering and anti-inflammatory effects, but statins have also been associated with neurotoxicity. We examined whether statin therapy affects the risk of DPN. RESEARCH DESIGN AND METHODS:We identified all Danish patients with incident type 2 diabetes during 2002-2016. New users initiated statins between 180 days before and 180 days after their first diabetes record, while prevalent users had initiated statins before that period. Patients were followed for incident DPN using validated hospital diagnosis codes, starting 180 days after their first diabetes record. Cox proportional hazard analysis was used to compute adjusted hazard ratios (aHRs) for DPN. RESULTS:The study cohort comprised 59,255 (23%) new users, 75,528 (29%) prevalent users, and 124,842 (48%) nonusers; median follow-up time was 6.2 years (interquartile range 3.4-9.6). The incidence rate of DPN events per 1,000 person-years was similar in new users (4.0 [95% CI 3.8-4.2]), prevalent users (3.8 [3.6-3.9]), and nonusers (3.8 [3.7-4.0]). The aHR for DPN was 1.05 (0.98-1.11) in new users and 0.97 (0.91-1.04) in prevalent users compared with statin nonusers. New users had a slightly increased DPN risk during the first year (1.31 [1.12-1.53]), which vanished after >2 years of follow-up. Findings were similar in on-treatment and propensity score-matched analyses and with additional adjustment for pretreatment blood lipid levels. CONCLUSIONS:Statin therapy is unlikely to increase or mitigate DPN risk in patients with type 2 diabetes, although a small acute risk of harm cannot be excluded.

journal_name

Diabetes Care

journal_title

Diabetes care

authors

Kristensen FP,Christensen DH,Callaghan BC,Kahlert J,Knudsen ST,Sindrup SH,Feldman EL,Østergaard L,Andersen H,Jensen TS,Sørensen HT,Thomsen RW

doi

10.2337/dc20-1004

subject

Has Abstract

pub_date

2020-12-01 00:00:00

pages

2945-2952

issue

12

eissn

0149-5992

issn

1935-5548

pii

dc20-1004

journal_volume

43

pub_type

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