다양한 당뇨병 환자들의 스타틴(statin) 사용 시 나타나는 LDL-C (저밀도 지방단백질 콜레스테롤) 조절 불균형에 대한 의사의 인식은 치료에 도움이 될 수 있습니다.
미국 NIH (National Institutes of Health, 국립보건연구원)에서 2003년부터 2007년 까지 시행되었던 다양한 인구적 특성을 바탕으로 한 뇌졸중 연구는 45세 이상이면서 LDL-C가 100mg/dL 초과인 총 4288 명의 당뇨병 환자들을 대상으로 이루어졌습니다.
전체 환자들 중 57.9% (n=2482)는 statin을 복용하였고, 그 결과 statin을 복용한 환자들의 65.4%의 LDL-C가 100mg/dL 미만으로 잘 조절 되었습니다.
이 연구에 참가한 환자들을 대상으로 한 통계에 따르면, statin의 복용은 백인남성(WM)의 66%, 흑인남성(BM)의 57.8%, 백인여성(WW)의 55%, 흑인여성(BW)의 53.6%가 복용하여 (P < 0.001), 복용하지 않은 대조군과 비슷한 비율을 나타냈습니다.
Statin을 복용한 환자들 중 백인남성의 75.3%, 흑인남성의 62.7%, 백인여성의 69%, 흑인여성의 56%에서 LCL콜레스테롤이 조절 되었습니다 (P<0.001).
이상지질혈증(dyslipidemia)의 진단 및 투약 순응도에 대한 조절은 스타틴을 복용하는 환자들에 대한 인종 및 성별 차이를 설명 하였고, 그 차이는 여전히 중요합니다.
보험 적용 등 인종간 갭을 줄이기 위해 좀 더 조절을 한 후에도 불구하고, 백인남성에 비해 흑인남성, 백인여성, 흑인여성의 LDL콜레스테롤 조절은 각각 15%, 11%, 27% 더 떨어지는 것으로 나타났다.
인종적 차이 이외에도, 스타틴 사용에 대한 차이는 당뇨가 심각한 정도, 관상동맥질환 병력의 유무 여부, 그리고 보험에 따라 그 차이와 치료결과가 크게 달라지는 것으로 밝혀졌습니다.
인종 및 다양한 특성으로 인해 스타틴 복용에 대한 치료결과에 차이가 있음에도 불구하고, 여전히 모든 당뇨환자들에게 심혈관질환 합병증 예방을 위해 스타틴은 중요한 의약품 입니다. 따라서 인종에 따라 스타틴 효과의 차이를 인지하되, 효과가 다소 떨어지는 인종에 대해서도 스타틴 처방의 중요성을 잊지 말아야 할 것입니다.
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