High intensity statin3/24/2023 We then performed logistic regressions that assessed the relation of demographic factors to high-statin, ezetimibe, PCSK9 inhibitor, and icosapent ethyl uses. The percentage of people on icosapent ethyl and with triglyceride levels less than 100 mg/dL, 100–149 mg/dL, 150 mg/dL to 199 mg/dL, and 200 mg/dL and greater were also analyzed using the Chi-squared test of proportions. We examined the percentage of people on low-, moderate-, and high-intensity statin therapy, and at LDL-C levels less than 70 mg/dL, 70–99 mg/dL, and 100 mg/dL or greater. The Chi-squared test of proportions was used to compare icosapent ethyl and statin use according to risk group, sex, and ethnicity. R programming was used for statistical analysis, utilizing the All of Us Research Program participants to project estimates to the US population. We also analyzed these parameters across health insurance status, education, and income categories. Risk factors included were age ≥60 years, hypertension (blood pressure ≥ 130/80 mmHg or being on antihypertensive therapy), low-density lipoprotein cholesterol (LDL-C) ≥ 160 mg/dL, cigarette smoking, and high-density lipoprotein cholesterol (HDL-C) < 40 mg/dL for males and <50 mg/dL for females ( Table 1). We categorized our ASCVD risk groups as moderate risk based on ≤1 CVD risk factor, high risk with ≥2 CVD risk factors, and DM with known ASCVD. Ethnicity within our cohort included non-Hispanic White, non-Hispanic Black, Hispanic or Latino, Asian, and other. We excluded participants with Type 1 DM and variables with missing values in our analysis from participants. ![]() On the researcher workbench, we created a cohort of 81,332 participants aged ≥ 18 years enrolled between 20 with DM based on ≥1 of the following from recorded personal or medical history: DM, DM without complications, type 2 DM, different diseases/conditions due to DM, secondary DM, on insulin treatment or DM medication, HbA1c ≥ 6.5%, fasting glucose ≥ 126 mg/dL, or non-fasting glucose ≥ 200 mg/dL. Moreover, clinical trials have shown that statin therapy, proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitor use, and fish oil therapy using pure icosapent ethyl all reduce ASCVD risk, including among those with DM. adults aged 20 years and over with diabetes in the US National Health and Nutrition Examination Survey, approximately 40% had triglyceride levels of ≥ 150 mg/dL, regardless of statin use and even among statin users with LDL-C < 70 mg/dL, one-third had borderline or elevated levels. Hypertriglyceridemia (HTG) also remains common in patients with DM. In the US Diabetes Collaborative Registry, among the 74,393 patients with DM, 48.6% had controlled levels of low-density lipoprotein-cholesterol (LDL-C) but only 62% were on a moderate- or high-intensity statin. Dyslipidemia remains a significant ASCVD risk factor in those with DM. Guideline-recommended use of high-intensity statins and non-statin therapy among our higher risk DM patients is lacking, with LDL-C inadequately controlled.Ītherosclerotic cardiovascular diseases (ASCVD) are major causes of morbidity and mortality in people with diabetes mellitus (DM). Those with DM and ASCVD were more likely to be on high-intensity statins, ezetimibe, and icosapent ethyl. Overall, 1.9% of participants with triglycerides ≥ 150 mg/dL were on icosapent ethyl. Among those with DM and ASCVD, only 21.1% had LDL-C < 70 mg/dL. Overall, 5.1% were using ezetimibe and 0.6% PCSK9 inhibitors. Only 18.2% of those with DM and ASCVD were on high-intensity statins. A total of 31.1% had ≤1 DM risk factor, 30.3% had ≥2 DM risk factors, and 38.6% of participants had DM with ASCVD. We studied 81,332 participants with DM, which included 22.3% non-Hispanic Black and 17.2% Hispanic. We examined the use of statin and non-statin therapy as well as LDL-C and triglyceride levels. ![]() In the All of Us Research Program, we categorized DM as (1) moderate risk (≤1 CVD risk factor), (2) high risk (≥2 CVD risk factors), and (3) DM with atherosclerotic CVD (ASCVD). We studied lipid levels and treatment status in patients with DM across cardiovascular disease (CVD) risk groups and sociodemographic factors. Real-world data on lipid levels and treatment among adults with diabetes mellitus (DM) are relatively limited.
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