Srikanth Tangelloju1,2, Bert B Little2, Robert J Esterhay2, Guy Brock3, Scott LaJoie4. 1. HUMANA Inc., Louisville, Kentucky, USA. 2. School of Public Health and Information Sciences, Department of Health Management and Systems Sciences, University of Louisville, Louisville, Kentucky, USA. 3. Department of Biostatistics and Center for Biostatistics, Ohio State University, Columbus, Ohio, USA. 4. School of Public Health and Information Sciences, Department of Behavioral Science and Health Promotion, University of Louisville, Louisville, Kentucky, USA.
Abstract
BACKGROUND: To evaluate the association of statins and co-morbidities with new onset type 2 diabetes mellitus (T2DM) in patients 65 years and older. METHODS: This retrospective study used de-identified administrative healthcare claims and enrolment data from a Medicare Advantage Prescription Drug (MAPD) health plan offered by a large multistate healthcare company. The plan covered >2.4 million individuals, of whom >1.7 million individuals were ≥65 years. Of these, 265 554 individuals had continuous MAPD enrolment January 2008 to December 2015. The unadjusted model assessed demographic, pharmacy and T2DM co-morbidities as covariates. Significant variables (P < .05) in the unadjusted model were then included in the adjusted model. The adjusted model used Cox proportional hazards to evaluate covariate effects. Matched propensity score analysis was used to analyse the association of statins and T2DM onset. RESULTS: The cumulative rate of diagnosed T2DM onset in the study cohort was 4.82% (4314/89 390). Annualised incidence of T2DM diagnosis was 0.82%, 0.88%, 1.04% and 2.09% in 2012, 2013, 2014 and 2015, respectively. T2DM onset was associated with male sex, non-white (African American or Hispanic ethnicity), statin use, hypertension, hyperlipidaemia, heart failure, lower limb ulceration, atherosclerosis, other retinopathy, angina pectoris, poor vision and blindness and absence ischaemic heart disease (IHD). Matched propensity score analysis showed that statin use was significantly associated with T2DM onset (Odds Ratio = 1.26, 95% Confidence Interval: 1.12-1.41, P < .0001) in the adjusted model. CONCLUSIONS: Analyses indicated that statin usage was associated with new onset T2DM after adjusting for covariates.
BACKGROUND: To evaluate the association of statins and co-morbidities with new onset type 2 diabetes mellitus (T2DM) in patients 65 years and older. METHODS: This retrospective study used de-identified administrative healthcare claims and enrolment data from a Medicare Advantage Prescription Drug (MAPD) health plan offered by a large multistate healthcare company. The plan covered >2.4 million individuals, of whom >1.7 million individuals were ≥65 years. Of these, 265 554 individuals had continuous MAPD enrolment January 2008 to December 2015. The unadjusted model assessed demographic, pharmacy and T2DM co-morbidities as covariates. Significant variables (P < .05) in the unadjusted model were then included in the adjusted model. The adjusted model used Cox proportional hazards to evaluate covariate effects. Matched propensity score analysis was used to analyse the association of statins and T2DM onset. RESULTS: The cumulative rate of diagnosed T2DM onset in the study cohort was 4.82% (4314/89 390). Annualised incidence of T2DM diagnosis was 0.82%, 0.88%, 1.04% and 2.09% in 2012, 2013, 2014 and 2015, respectively. T2DM onset was associated with male sex, non-white (African American or Hispanic ethnicity), statin use, hypertension, hyperlipidaemia, heart failure, lower limb ulceration, atherosclerosis, other retinopathy, angina pectoris, poor vision and blindness and absence ischaemic heart disease (IHD). Matched propensity score analysis showed that statin use was significantly associated with T2DM onset (Odds Ratio = 1.26, 95% Confidence Interval: 1.12-1.41, P < .0001) in the adjusted model. CONCLUSIONS: Analyses indicated that statin usage was associated with new onset T2DM after adjusting for covariates.
Authors: Anton P van de Woestijne; Yolanda van der Graaf; Jan Westerink; Hendrik M Nathoe; Frank L J Visseren Journal: Am J Cardiol Date: 2014-11-29 Impact factor: 2.778