# Body mass index impacts the lipid-lowing effects of statins in patients with type 2 diabetes

## TL;DR

Higher BMI in type 2 diabetes patients may lead to greater cholesterol reduction from statin therapy.

## Contribution

This study shows that higher BMI is associated with better LDL reduction in T2DM patients on statins.

## Key findings

- Obese patients had the highest LDL reduction compared to normal and overweight groups.
- Obese patients were more likely to achieve lipid control targets than normal-weight patients.
- Statin effectiveness in lowering lipids varies with BMI in T2DM patients.

## Abstract

Individuals diagnosed with type 2 diabetes mellitus (T2DM) commonly exhibit elevated lipid levels and an increased body mass index (BMI). The impact of BMI on the efficacy of statins in reducing lipid levels among diabetic patients remains uncertain. We aim to evaluate whether BMI will affect the lipid-lowing effects of statins in patients with T2DM.

In this retrospective analysis, we screened T2DM patients who were prescribed statins and underwent a 1-year outpatient follow-up recorded in the electronic medical record system. Patients were stratified into three groups: normal weight (BMI < 24 kg/m), overweight (24 kg/m2 ≤ BMI < 28 kg/m2), and obese (BMI ≥ 28 kg/m2). Lipid levels were assessed at two time points, and multivariate logistic regression analysis was used to identify factors influencing the reduction of low-density lipoprotein-cholesterol (LDL-C) levels and lipid control achievement.

This study included 289 patients, with 82 in normal weigh, 143 in overweight, and 64 in obese. Overweight and obese patients were found to be younger than those with normal weight. Over the 1-year follow-up period, lipid levels decreased in all patients, with a significant reduction observed in LDL-C levels. Notably, obese patients experienced the highest reduction in LDL-C levels compared to the normal and overweight groups (normal weight group ΔLDL 0.78 ± 0.95 mmol/L, p < 0.001; overweight group ΔLDL 0.80 ± 0.88 mmol/L, p < 0.001; obese group ΔLDL 1.11 ± 0.82 mmol/L, p < 0.038). Obese patients exhibited a remarkable 42.02% reduction in LDL levels (normal 27.45%, overweight 30.64%). Multivariate logistic regression analysis indicated that achieving lipid control, defined as LDL < 2.6 mmol/L, was more likely in obese patients compared to those with normal weight [odds ratio [OR] 3.48, 95% confidence interval [CI]: 1.18, 10.21, p = 0.023].

The effectiveness of statins in lowering lipid levels appears to be influenced by the patient's BMI in patients with T2DM. T2DM patients with high BMI may derive greater benefits, particularly in LDL reduction, from statin therapy.