Simvastatin is associated with superior lipid and glycaemic control to atorvastatin and reduced levels of incident Type 2 diabetes, in men and women, in the UK Biobank

Andrew R. English; Bodhayan Prasad; Declan H. McGuigan; Geraldine Horigan; Maurice O’Kane; Anthony J. Bjourson; Priyank Shukla; Catriona Kelly; Paula L. McClean

doi:10.1002/edm2.326

Simvastatin is associated with superior lipid and glycaemic control to atorvastatin and reduced levels of incident Type 2 diabetes, in men and women, in the UK Biobank

Andrew R. English, Bodhayan Prasad, Declan H. McGuigan, Geraldine Horigan, Maurice O’Kane, Anthony J. Bjourson, Priyank Shukla, Catriona Kelly, Paula L. McClean

Research output: Contribution to journal › Article › peer-review

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Abstract

Introduction: Cardiovascular disease (CVD) is the leading cause of mortality in people with Type 2 diabetes mellitus (T2DM). Statins reduce low-density lipoproteins and positively affect CVD outcomes. Statin type and dose have differential effects on glycaemia and risk of incident T2DM; however, the impact of gender, and of individual drugs within the statin class, remains unclear. Aim: To compare effects of simvastatin and atorvastatin on lipid and glycaemic control in men and women with and without T2DM, and their association with incident T2DM. Methods: The effect of simvastatin and atorvastatin on lipid and glycaemic control was assessed in the T2DM DiaStrat cohort. Prescribed medications, gender, age, BMI, diabetes duration, blood lipid profile and HbA1c were extracted from Electronic Care Record, and compared in men and women prescribed simvastatin and atorvastatin. Analyses were replicated in the UKBiobank in those with and without T2DM. The association of simvastatin and atorvastatin with incident T2DM was also investigated in the UKBiobank. Cohorts where matched for age, BMI and diabetes duration in men and women, in the UKBioBank analysis, where possible. Results: Simvastatin was associated with better LDL (1.6 ± 0.6 vs 2.1 ± 0.9 mmol/L, p <.01) and total cholesterol (3.6 ± 0.7 vs 4.2 ± 1.0 mmol/L, p <.05), and glycaemic control (62 ± 17 vs 67 ± 19 mmol/mol, p <.059) than atorvastatin specifically in women in the DiaStrat cohort. In the UKBiobank, both men and women prescribed simvastatin had better LDL (Women: 2.6 ± 0.6 vs 2.6 ± 0.7 mmol/L, p <.05; Men: 2.4 ± 0.6 vs 2.4 ± 0.6, p <.01) and glycaemic control (Women:54 ± 14 vs 56 ± 15mmol/mol, p <.05; Men, 54 ± 14 vs 55 ± 15 mmol/mol, p <.01) than those prescribed atorvastatin. Simvastatin was also associated with reduced risk of incident T2DM in both men and women (p <.0001) in the UKBiobank. Conclusions: Simvastatin is associated with superior lipid and glycaemic control to atorvastatin in those with and without T2DM, and with fewer incident T2DM cases. Given the importance of lipid and glycaemic control in preventing secondary complications of T2DM, these findings may help inform prescribing practices.

Original language	English
Article number	e00326
Pages (from-to)	1-13
Number of pages	13
Journal	Endocrinology, Diabetes & Metabolism
Volume	5
Issue number	3
Early online date	4 Mar 2022
DOIs	https://doi.org/10.1002/edm2.326
Publication status	Published (in print/issue) - May 2022

Bibliographical note

Funding Information:
We would like to extend our sincere gratitude to the participants of this study for their invaluable contribution and to the Western Health Social Care Trust, Northern Ireland, for facilitating access to participants and clinics. This study was approved by the Research Ethics Committee Northern Ireland (ORECNI; REC reference 14/NI/1123) and adhered to all Good Clinical Practice (GCP) guidelines. This work was supported by an £11.5M grant awarded to Professor Tony Bjourson from European Union Regional Development Fund (ERDF) EU Sustainable Competitiveness Programme for N. Ireland; Northern Ireland Public Health Agency (HSC R&D) & Ulster University.

Publisher Copyright:
© 2022 The Authors. Endocrinology, Diabetes & Metabolism published by John Wiley & Sons Ltd.

Funding Information:
We would like to extend our sincere gratitude to the participants of this study for their invaluable contribution and to the Western Health Social Care Trust, Northern Ireland, for facilitating access to participants and clinics. This study was approved by the Research Ethics Committee Northern Ireland (ORECNI; REC reference 14/NI/1123) and adhered to all Good Clinical Practice (GCP) guidelines. This work was supported by an £11.5M grant awarded to Professor Tony Bjourson from European Union Regional Development Fund (ERDF) EU Sustainable Competitiveness Programme for N. Ireland; Northern Ireland Public Health Agency (HSC R&D) & Ulster University.

Funding Information:
We would like to extend our sincere gratitude to the participants of this study for their invaluable contribution and to the Western Health Social Care Trust, Northern Ireland, for facilitating access to participants and clinics. This study was approved by the Research Ethics Committee Northern Ireland (ORECNI; REC reference 14/NI/1123) and adhered to all Good Clinical Practice (GCP) guidelines. This work was supported by an £11.5M grant awarded to Professor Tony Bjourson from European Union Regional Development Fund (ERDF) EU Sustainable Competitiveness Programme for N. Ireland; Northern Ireland Public Health Agency (HSC R&D) & Ulster University.

Publisher Copyright:
© 2022 The Authors. Endocrinology, Diabetes & Metabolism published by John Wiley & Sons Ltd.

Keywords

Endocrinology
RESEARCH ARTICLES
gender differences
glycaemic control
HbA1c
lipid control
statin
type 2 diabetes
UK Biobank
Diabetes and Metabolism
Cardiovascular Diseases/epidemiology
Humans
Glycemic Control
Male
Simvastatin/therapeutic use
United Kingdom/epidemiology
Lipids/therapeutic use
Diabetes Mellitus, Type 2/drug therapy
Biological Specimen Banks
Hydroxymethylglutaryl-CoA Reductase Inhibitors/therapeutic use
Female
Atorvastatin/therapeutic use

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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English, A. R., Prasad, B., McGuigan, D. H., Horigan, G., O’Kane, M., Bjourson, A. J., Shukla, P., Kelly, C., & McClean, P. L. (2022). Simvastatin is associated with superior lipid and glycaemic control to atorvastatin and reduced levels of incident Type 2 diabetes, in men and women, in the UK Biobank. Endocrinology, Diabetes & Metabolism, 5(3), 1-13. Article e00326. https://doi.org/10.1002/edm2.326

@article{fb3b4fbef0cb4f44ae491ef2b8ea2570,

title = "Simvastatin is associated with superior lipid and glycaemic control to atorvastatin and reduced levels of incident Type 2 diabetes, in men and women, in the UK Biobank",

abstract = "Introduction: Cardiovascular disease (CVD) is the leading cause of mortality in people with Type 2 diabetes mellitus (T2DM). Statins reduce low-density lipoproteins and positively affect CVD outcomes. Statin type and dose have differential effects on glycaemia and risk of incident T2DM; however, the impact of gender, and of individual drugs within the statin class, remains unclear. Aim: To compare effects of simvastatin and atorvastatin on lipid and glycaemic control in men and women with and without T2DM, and their association with incident T2DM. Methods: The effect of simvastatin and atorvastatin on lipid and glycaemic control was assessed in the T2DM DiaStrat cohort. Prescribed medications, gender, age, BMI, diabetes duration, blood lipid profile and HbA1c were extracted from Electronic Care Record, and compared in men and women prescribed simvastatin and atorvastatin. Analyses were replicated in the UKBiobank in those with and without T2DM. The association of simvastatin and atorvastatin with incident T2DM was also investigated in the UKBiobank. Cohorts where matched for age, BMI and diabetes duration in men and women, in the UKBioBank analysis, where possible. Results: Simvastatin was associated with better LDL (1.6 ± 0.6 vs 2.1 ± 0.9 mmol/L, p <.01) and total cholesterol (3.6 ± 0.7 vs 4.2 ± 1.0 mmol/L, p <.05), and glycaemic control (62 ± 17 vs 67 ± 19 mmol/mol, p <.059) than atorvastatin specifically in women in the DiaStrat cohort. In the UKBiobank, both men and women prescribed simvastatin had better LDL (Women: 2.6 ± 0.6 vs 2.6 ± 0.7 mmol/L, p <.05; Men: 2.4 ± 0.6 vs 2.4 ± 0.6, p <.01) and glycaemic control (Women:54 ± 14 vs 56 ± 15mmol/mol, p <.05; Men, 54 ± 14 vs 55 ± 15 mmol/mol, p <.01) than those prescribed atorvastatin. Simvastatin was also associated with reduced risk of incident T2DM in both men and women (p <.0001) in the UKBiobank. Conclusions: Simvastatin is associated with superior lipid and glycaemic control to atorvastatin in those with and without T2DM, and with fewer incident T2DM cases. Given the importance of lipid and glycaemic control in preventing secondary complications of T2DM, these findings may help inform prescribing practices.",

keywords = "Endocrinology, RESEARCH ARTICLES, gender differences, glycaemic control, HbA1c, lipid control, statin, type 2 diabetes, UK Biobank, Diabetes and Metabolism, Cardiovascular Diseases/epidemiology, Humans, Glycemic Control, Male, Simvastatin/therapeutic use, United Kingdom/epidemiology, Lipids/therapeutic use, Diabetes Mellitus, Type 2/drug therapy, Biological Specimen Banks, Hydroxymethylglutaryl-CoA Reductase Inhibitors/therapeutic use, Female, Atorvastatin/therapeutic use",

author = "English, {Andrew R.} and Bodhayan Prasad and McGuigan, {Declan H.} and Geraldine Horigan and Maurice O{\textquoteright}Kane and Bjourson, {Anthony J.} and Priyank Shukla and Catriona Kelly and McClean, {Paula L.}",

note = "Funding Information: We would like to extend our sincere gratitude to the participants of this study for their invaluable contribution and to the Western Health Social Care Trust, Northern Ireland, for facilitating access to participants and clinics. This study was approved by the Research Ethics Committee Northern Ireland (ORECNI; REC reference 14/NI/1123) and adhered to all Good Clinical Practice (GCP) guidelines. This work was supported by an £11.5M grant awarded to Professor Tony Bjourson from European Union Regional Development Fund (ERDF) EU Sustainable Competitiveness Programme for N. Ireland; Northern Ireland Public Health Agency (HSC R&D) & Ulster University. Publisher Copyright: {\textcopyright} 2022 The Authors. Endocrinology, Diabetes & Metabolism published by John Wiley & Sons Ltd. Funding Information: We would like to extend our sincere gratitude to the participants of this study for their invaluable contribution and to the Western Health Social Care Trust, Northern Ireland, for facilitating access to participants and clinics. This study was approved by the Research Ethics Committee Northern Ireland (ORECNI; REC reference 14/NI/1123) and adhered to all Good Clinical Practice (GCP) guidelines. This work was supported by an £11.5M grant awarded to Professor Tony Bjourson from European Union Regional Development Fund (ERDF) EU Sustainable Competitiveness Programme for N. Ireland; Northern Ireland Public Health Agency (HSC R&D) & Ulster University. Funding Information: We would like to extend our sincere gratitude to the participants of this study for their invaluable contribution and to the Western Health Social Care Trust, Northern Ireland, for facilitating access to participants and clinics. This study was approved by the Research Ethics Committee Northern Ireland (ORECNI; REC reference 14/NI/1123) and adhered to all Good Clinical Practice (GCP) guidelines. This work was supported by an £11.5M grant awarded to Professor Tony Bjourson from European Union Regional Development Fund (ERDF) EU Sustainable Competitiveness Programme for N. Ireland; Northern Ireland Public Health Agency (HSC R&D) & Ulster University. Publisher Copyright: {\textcopyright} 2022 The Authors. Endocrinology, Diabetes & Metabolism published by John Wiley & Sons Ltd.",

year = "2022",

month = may,

doi = "10.1002/edm2.326",

language = "English",

volume = "5",

pages = "1--13",

journal = "Endocrinology, Diabetes & Metabolism",

issn = "2398-9238",

publisher = "Wiley-Blackwell Publishing Ltd",

number = "3",

}

English, AR, Prasad, B, McGuigan, DH, Horigan, G, O’Kane, M, Bjourson, AJ , Shukla, P , Kelly, C & McClean, PL 2022, 'Simvastatin is associated with superior lipid and glycaemic control to atorvastatin and reduced levels of incident Type 2 diabetes, in men and women, in the UK Biobank', Endocrinology, Diabetes & Metabolism, vol. 5, no. 3, e00326, pp. 1-13. https://doi.org/10.1002/edm2.326

Simvastatin is associated with superior lipid and glycaemic control to atorvastatin and reduced levels of incident Type 2 diabetes, in men and women, in the UK Biobank. / English, Andrew R.; Prasad, Bodhayan; McGuigan, Declan H. et al.
In: Endocrinology, Diabetes & Metabolism, Vol. 5, No. 3, e00326, 05.2022, p. 1-13.

Research output: Contribution to journal › Article › peer-review

TY - JOUR

T1 - Simvastatin is associated with superior lipid and glycaemic control to atorvastatin and reduced levels of incident Type 2 diabetes, in men and women, in the UK Biobank

AU - English, Andrew R.

AU - Prasad, Bodhayan

AU - McGuigan, Declan H.

AU - Horigan, Geraldine

AU - O’Kane, Maurice

AU - Bjourson, Anthony J.

AU - Shukla, Priyank

AU - Kelly, Catriona

AU - McClean, Paula L.

N1 - Funding Information: We would like to extend our sincere gratitude to the participants of this study for their invaluable contribution and to the Western Health Social Care Trust, Northern Ireland, for facilitating access to participants and clinics. This study was approved by the Research Ethics Committee Northern Ireland (ORECNI; REC reference 14/NI/1123) and adhered to all Good Clinical Practice (GCP) guidelines. This work was supported by an £11.5M grant awarded to Professor Tony Bjourson from European Union Regional Development Fund (ERDF) EU Sustainable Competitiveness Programme for N. Ireland; Northern Ireland Public Health Agency (HSC R&D) & Ulster University. Publisher Copyright: © 2022 The Authors. Endocrinology, Diabetes & Metabolism published by John Wiley & Sons Ltd. Funding Information: We would like to extend our sincere gratitude to the participants of this study for their invaluable contribution and to the Western Health Social Care Trust, Northern Ireland, for facilitating access to participants and clinics. This study was approved by the Research Ethics Committee Northern Ireland (ORECNI; REC reference 14/NI/1123) and adhered to all Good Clinical Practice (GCP) guidelines. This work was supported by an £11.5M grant awarded to Professor Tony Bjourson from European Union Regional Development Fund (ERDF) EU Sustainable Competitiveness Programme for N. Ireland; Northern Ireland Public Health Agency (HSC R&D) & Ulster University. Funding Information: We would like to extend our sincere gratitude to the participants of this study for their invaluable contribution and to the Western Health Social Care Trust, Northern Ireland, for facilitating access to participants and clinics. This study was approved by the Research Ethics Committee Northern Ireland (ORECNI; REC reference 14/NI/1123) and adhered to all Good Clinical Practice (GCP) guidelines. This work was supported by an £11.5M grant awarded to Professor Tony Bjourson from European Union Regional Development Fund (ERDF) EU Sustainable Competitiveness Programme for N. Ireland; Northern Ireland Public Health Agency (HSC R&D) & Ulster University. Publisher Copyright: © 2022 The Authors. Endocrinology, Diabetes & Metabolism published by John Wiley & Sons Ltd.

PY - 2022/5

Y1 - 2022/5

N2 - Introduction: Cardiovascular disease (CVD) is the leading cause of mortality in people with Type 2 diabetes mellitus (T2DM). Statins reduce low-density lipoproteins and positively affect CVD outcomes. Statin type and dose have differential effects on glycaemia and risk of incident T2DM; however, the impact of gender, and of individual drugs within the statin class, remains unclear. Aim: To compare effects of simvastatin and atorvastatin on lipid and glycaemic control in men and women with and without T2DM, and their association with incident T2DM. Methods: The effect of simvastatin and atorvastatin on lipid and glycaemic control was assessed in the T2DM DiaStrat cohort. Prescribed medications, gender, age, BMI, diabetes duration, blood lipid profile and HbA1c were extracted from Electronic Care Record, and compared in men and women prescribed simvastatin and atorvastatin. Analyses were replicated in the UKBiobank in those with and without T2DM. The association of simvastatin and atorvastatin with incident T2DM was also investigated in the UKBiobank. Cohorts where matched for age, BMI and diabetes duration in men and women, in the UKBioBank analysis, where possible. Results: Simvastatin was associated with better LDL (1.6 ± 0.6 vs 2.1 ± 0.9 mmol/L, p <.01) and total cholesterol (3.6 ± 0.7 vs 4.2 ± 1.0 mmol/L, p <.05), and glycaemic control (62 ± 17 vs 67 ± 19 mmol/mol, p <.059) than atorvastatin specifically in women in the DiaStrat cohort. In the UKBiobank, both men and women prescribed simvastatin had better LDL (Women: 2.6 ± 0.6 vs 2.6 ± 0.7 mmol/L, p <.05; Men: 2.4 ± 0.6 vs 2.4 ± 0.6, p <.01) and glycaemic control (Women:54 ± 14 vs 56 ± 15mmol/mol, p <.05; Men, 54 ± 14 vs 55 ± 15 mmol/mol, p <.01) than those prescribed atorvastatin. Simvastatin was also associated with reduced risk of incident T2DM in both men and women (p <.0001) in the UKBiobank. Conclusions: Simvastatin is associated with superior lipid and glycaemic control to atorvastatin in those with and without T2DM, and with fewer incident T2DM cases. Given the importance of lipid and glycaemic control in preventing secondary complications of T2DM, these findings may help inform prescribing practices.

AB - Introduction: Cardiovascular disease (CVD) is the leading cause of mortality in people with Type 2 diabetes mellitus (T2DM). Statins reduce low-density lipoproteins and positively affect CVD outcomes. Statin type and dose have differential effects on glycaemia and risk of incident T2DM; however, the impact of gender, and of individual drugs within the statin class, remains unclear. Aim: To compare effects of simvastatin and atorvastatin on lipid and glycaemic control in men and women with and without T2DM, and their association with incident T2DM. Methods: The effect of simvastatin and atorvastatin on lipid and glycaemic control was assessed in the T2DM DiaStrat cohort. Prescribed medications, gender, age, BMI, diabetes duration, blood lipid profile and HbA1c were extracted from Electronic Care Record, and compared in men and women prescribed simvastatin and atorvastatin. Analyses were replicated in the UKBiobank in those with and without T2DM. The association of simvastatin and atorvastatin with incident T2DM was also investigated in the UKBiobank. Cohorts where matched for age, BMI and diabetes duration in men and women, in the UKBioBank analysis, where possible. Results: Simvastatin was associated with better LDL (1.6 ± 0.6 vs 2.1 ± 0.9 mmol/L, p <.01) and total cholesterol (3.6 ± 0.7 vs 4.2 ± 1.0 mmol/L, p <.05), and glycaemic control (62 ± 17 vs 67 ± 19 mmol/mol, p <.059) than atorvastatin specifically in women in the DiaStrat cohort. In the UKBiobank, both men and women prescribed simvastatin had better LDL (Women: 2.6 ± 0.6 vs 2.6 ± 0.7 mmol/L, p <.05; Men: 2.4 ± 0.6 vs 2.4 ± 0.6, p <.01) and glycaemic control (Women:54 ± 14 vs 56 ± 15mmol/mol, p <.05; Men, 54 ± 14 vs 55 ± 15 mmol/mol, p <.01) than those prescribed atorvastatin. Simvastatin was also associated with reduced risk of incident T2DM in both men and women (p <.0001) in the UKBiobank. Conclusions: Simvastatin is associated with superior lipid and glycaemic control to atorvastatin in those with and without T2DM, and with fewer incident T2DM cases. Given the importance of lipid and glycaemic control in preventing secondary complications of T2DM, these findings may help inform prescribing practices.

KW - Endocrinology

KW - RESEARCH ARTICLES

KW - gender differences

KW - glycaemic control

KW - HbA1c

KW - lipid control

KW - statin

KW - type 2 diabetes

KW - UK Biobank

KW - Diabetes and Metabolism

KW - Cardiovascular Diseases/epidemiology

KW - Humans

KW - Glycemic Control

KW - Male

KW - Simvastatin/therapeutic use

KW - United Kingdom/epidemiology

KW - Lipids/therapeutic use

KW - Diabetes Mellitus, Type 2/drug therapy

KW - Biological Specimen Banks

KW - Hydroxymethylglutaryl-CoA Reductase Inhibitors/therapeutic use

KW - Female

KW - Atorvastatin/therapeutic use

UR - http://www.scopus.com/inward/record.url?scp=85125600174&partnerID=8YFLogxK

U2 - 10.1002/edm2.326

DO - 10.1002/edm2.326

M3 - Article

C2 - 35243827

SN - 2398-9238

VL - 5

SP - 1

EP - 13

JO - Endocrinology, Diabetes & Metabolism

JF - Endocrinology, Diabetes & Metabolism

IS - 3

M1 - e00326

ER -

Simvastatin is associated with superior lipid and glycaemic control to atorvastatin and reduced levels of incident Type 2 diabetes, in men and women, in the UK Biobank

Abstract

Bibliographical note

Keywords

UN SDGs

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