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.
Bibliographical noteFunding 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.
© 2022 The Authors. Endocrinology, Diabetes & Metabolism published by John Wiley & Sons Ltd.
- RESEARCH ARTICLES
- gender differences
- glycaemic control
- lipid control
- type 2 diabetes
- UK Biobank
- Diabetes and Metabolism