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Association of metformin and statin medications with surrogate measures of cardiovascular disease in youth with type 1 diabetes: the SEARCH for diabetes in youth study

Annals of Pediatric Endocrinology & Metabolism 2019년 24권 3호 p.187 ~ 194
 ( Gourgari Evgenia ) - Georgetown University Department of Pediatrics

 ( Stafford Jeanette M. ) - Wake Forest School of Medicine Department of Biostatistical Sciences
 ( D’Agostino Ralph Jr. ) - Wake Forest School of Medicine Department of Biostatistical Sciences
 ( Dolan Lawrence M. ) - University of Cincinnati Cincinnati Children’s Hospital Department of Pediatrics
 ( Lawrence Jean M. ) - Kaiser Permanente Southern California Department of Research and Evaluation
 ( Mottl Amy ) - University of North Carolina School of Medicine Division of Nephrology and Hypertension
 ( Pihoker Catherine ) - University of Washington Department of Pediatrics
 ( Urbina Elaine M. ) - University of Cincinnati Cincinnati Children’s Hospital Medical Center
 ( Wadwa R. Paul ) - University of Colorado School of Medicine Barbara Davis Center for Childhood Diabetes
 ( Dabelea Dana ) - University of Colorado Denver Colorado School of Public Health Department of Epidemiology

Abstract


Purpose: Youth with type 1 diabetes mellitus (T1DM) are at risk of cardiovascular disease (CVD). We evaluated if metformin or statin use was associated with surrogate measures of improved CVD.

Methods: We included participants from the SEARCH observational study. Participants treated with insulin plus metformin (n=42) or insulin plus statin (n=39) were matched with 84 and 78 participants, respectively, treated with insulin alone. Measures of arterial stiffness obtained were pulse wave velocity (PWV), augmentation index (AI75), and heart rate variability as standard deviation of the normal-to-normal interval (SDNN) and root mean square differences of successive NN intervals (RMSSD).

Results: CVD measures were not significantly different among participants on insulin plus metformin versus those on insulin alone: PWV (5.9±1.0 m/sec vs. 5.8±1.5 m/sec, P=0.730), AI75 (1.8 [-6.0 to 8.0] vs. -2.4 [-10.7 to 3.8], P=0.157), SDNN (52.4 [36.8?71.1] m/sec vs. 51.8 [40.1?74.9] m/sec, P=0.592), and RMSSD (43.2 [29.4?67.6] vs. 47.4 [28.0?76.3], P=0.952). CVD measures were not different for statin users versus nonusers: PWV (5.7±0.8 m/sec vs. 5.9 ±1.1 m/sec, P=0.184), AI75 ( -4.0 [-9.5 to 1.7] vs. -6.7 [-11.3 to 5.7], P=0.998), SDNN (54.6 [43.5?77.2] m/sec vs. 63.1 [44.2?86.6] m/sec, P=0.369), and RMSSD (49.5 [31.2?74.8] vs. 59.2 [38.3?86.3], P=0.430).

Conclusions: We found no associations of statin or metformin use with surrogate measures of CVD. Future prospective pediatric clinical trials could address this issue.

키워드

Metformin; Type 1 diabetes; Adolescents; Statin; Cardiovascular disease
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