LDL-cholesterol trajectories and statin treatment in Finnish type 2 diabetes patients: a growth mixture model

Abstract We aimed to identify distinct longitudinal trends of LDL-cholesterol (LDL-C) levels and investigate these trajectories’ association with statin treatment. This retrospective cohort study used electronic health records from 8592 type 2 diabetes patients in North Karelia, Finland, comprising...

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Autores principales:	Laura Inglin, Piia Lavikainen, Kari Jalkanen, Tiina Laatikainen
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/4c8a021b23184b2b8b329e1270eb3ba9
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spelling	oai:doaj.org-article:4c8a021b23184b2b8b329e1270eb3ba92021-11-21T12:16:25ZLDL-cholesterol trajectories and statin treatment in Finnish type 2 diabetes patients: a growth mixture model10.1038/s41598-021-02077-62045-2322https://doaj.org/article/4c8a021b23184b2b8b329e1270eb3ba92021-11-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-02077-6https://doaj.org/toc/2045-2322Abstract We aimed to identify distinct longitudinal trends of LDL-cholesterol (LDL-C) levels and investigate these trajectories’ association with statin treatment. This retrospective cohort study used electronic health records from 8592 type 2 diabetes patients in North Karelia, Finland, comprising all primary and specialised care visits 2011‒2017. We compared LDL-C trajectory groups assessing LDL-C treatment target achievement and changes in statin treatment intensity. Using a growth mixture model, we identified four LDL-C trajectory groups. The majority (85.9%) had “moderate-stable” LDL-C levels around 2.3 mmol/L. The second-largest group (7.7%) consisted of predominantly untreated patients with alarmingly “high-stable” LDL-C levels around 3.9 mmol/L. The “decreasing” group (3.8%) was characterised by large improvements in initially very high LDL-C levels, along with the highest statin treatment intensification rates, while among patients with “increasing” LDL-C (2.5%), statin treatment declined drastically. In all the trajectory groups, women had significantly higher average LDL-C levels and received less frequent any statin treatment and high-intensity treatment than men. Overall, 41.9% of patients had no statin prescribed at the end of follow-up. Efforts to control LDL-C should be increased—especially in patients with continuously elevated levels—by initiating and intensifying statin treatment earlier and re-initiating the treatment after discontinuation if possible.Laura InglinPiia LavikainenKari JalkanenTiina LaatikainenNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-11 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Laura Inglin Piia Lavikainen Kari Jalkanen Tiina Laatikainen LDL-cholesterol trajectories and statin treatment in Finnish type 2 diabetes patients: a growth mixture model
description	Abstract We aimed to identify distinct longitudinal trends of LDL-cholesterol (LDL-C) levels and investigate these trajectories’ association with statin treatment. This retrospective cohort study used electronic health records from 8592 type 2 diabetes patients in North Karelia, Finland, comprising all primary and specialised care visits 2011‒2017. We compared LDL-C trajectory groups assessing LDL-C treatment target achievement and changes in statin treatment intensity. Using a growth mixture model, we identified four LDL-C trajectory groups. The majority (85.9%) had “moderate-stable” LDL-C levels around 2.3 mmol/L. The second-largest group (7.7%) consisted of predominantly untreated patients with alarmingly “high-stable” LDL-C levels around 3.9 mmol/L. The “decreasing” group (3.8%) was characterised by large improvements in initially very high LDL-C levels, along with the highest statin treatment intensification rates, while among patients with “increasing” LDL-C (2.5%), statin treatment declined drastically. In all the trajectory groups, women had significantly higher average LDL-C levels and received less frequent any statin treatment and high-intensity treatment than men. Overall, 41.9% of patients had no statin prescribed at the end of follow-up. Efforts to control LDL-C should be increased—especially in patients with continuously elevated levels—by initiating and intensifying statin treatment earlier and re-initiating the treatment after discontinuation if possible.
format	article
author	Laura Inglin Piia Lavikainen Kari Jalkanen Tiina Laatikainen
author_facet	Laura Inglin Piia Lavikainen Kari Jalkanen Tiina Laatikainen
author_sort	Laura Inglin
title	LDL-cholesterol trajectories and statin treatment in Finnish type 2 diabetes patients: a growth mixture model
title_short	LDL-cholesterol trajectories and statin treatment in Finnish type 2 diabetes patients: a growth mixture model
title_full	LDL-cholesterol trajectories and statin treatment in Finnish type 2 diabetes patients: a growth mixture model
title_fullStr	LDL-cholesterol trajectories and statin treatment in Finnish type 2 diabetes patients: a growth mixture model
title_full_unstemmed	LDL-cholesterol trajectories and statin treatment in Finnish type 2 diabetes patients: a growth mixture model
title_sort	ldl-cholesterol trajectories and statin treatment in finnish type 2 diabetes patients: a growth mixture model
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/4c8a021b23184b2b8b329e1270eb3ba9
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LDL-cholesterol trajectories and statin treatment in Finnish type 2 diabetes patients: a growth mixture model

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