Usporedba stvarnog profila lipida u bolesnika s dijabetesom tip 2 i preporuka iz smjernica

Diabetes is a major risk factor for cardiovascular disease. Despite recommendations and available therapeutic options, patients with diabetes do not always reach the recommended lipid levels. In this study, our aim was to compare the real world lipid profile of type 2 diabetes patients with guideline recommendations for dyslipidemia. Four hundred and sixty eight consecutive patients referred to Outpatient Diabetes Clinic of Istanbul Medeniyet University were recruited. Patient anthropometric measurements (height, weight, waist circumference), biochemical test results (LDL cholesterol (LDL-c), triglycerides, HDL cholesterol, HbA1c) and treatment modalities were recorded. Patients were stratified into cardiovascular risk categories according to the risk factors and their treatment dose was compared to the recommendations. Among 468 patients, 56 (12%) patients had coronary heart disease (CHD). Thirty-four percent of these patients were not on statin treatment (n=19) and their mean LDL-c level was 114±29 mg/dL (2.9±0.75 mmol/L). Nineteen percent of these patients were on high intensity statin treatment (atorvastatin 40-80 mg, rosuvastatin 20 mg). Only four patients with CHD had LDL-c levels <70 mg/dL (1.8 mmol/L). Four hundred and twelve patients had no CHD. In these patients, the mean LDL-c level was 132±38 mg/dL (3.4±0.9 mmol/L). Eighty (19%) patients had LDL-c level lower than 100 mg/dL (2.5 mmol/L). Overall 82% (n=384) of the cohort had not achieved treatment goal. In conclusion, a more pronounced approach for statin treatment is needed in diabetes patients for both primary and secondary prevention of cardiovascular diseases.Dijabetes je glavni čimbenik rizika za srčanožilne bolesti. Usprkos preporuka i dostupnih terapijskih mogućnosti bolesnici s dijabetesom ne postižu uvijek preporučene razine lipida. Cilj ovoga istraživanja bio je usporediti stvarni profil lipida u bolesnika s dijabetesom tip 2 s preporukama za dislipidemiju iz dotičnih smjernica. U istraživanje je bilo uključeno 468 uzastopnih bolesnika upućenih u Ambulantu za dijabetes Sveučilišta Medeniyet u Istanbulu. Bilježena su antropometrijska mjerenja (visina, težina, opseg struka), rezultati biokemijskih pretraga (LDL kolesterol, trigliceridi, HDL kolesterol, HbA1c) i načini liječenja. Bolesnici su podijeljeni u skupine kardiovaskularnog rizika prema rizičnim čimbenicima, a doze lijeka kojom su liječeni uspoređene su s preporukama. Među 468 bolesnika 56 (12%) ih je imalo koronarnu srčanu bolest (KSB); 34% (n=19) tih bolesnika nije primalo terapiju statinima, a njihova srednja razina LDL bila je 114±29 mg/dL (2,9±0,75 mmol/L); 19% tih bolesnika primalo je visoko intenzivnu terapiju statinima (atorvastatin 40-80 mg, rosuvastatin 20 mg). Razine LDL <70 mg/dL (1,8 mmol/L) zabilježene su u samo četvero bolesnika s KSB. Četiristodvanaest bolesnika nije imalo KSB. U ovih bolesnika srednja razina LDL bila je 132±38 mg/dL (3,4±0,9 mmol/L). Razine LDL niže od 100 mg/ dL (2,5 mmol/L) zabilježene su u 80 (19%) bolesnika s LDL. Dakle, cilj liječenja sveukupno nije postignut u 82% (n=384) ispitivanih bolesnika. Zaključuje se kako je potreban snažniji pristup terapiji statinima u bolesnika s dijabetesom kako za primarnu tako i za sekundarnu prevenciju srčanožilnih bolesti