A proposed explanation for this dose-effect difference was genetic variability in drug metabolism. However, previous data suggested that Asians achieved plasma LDL-C reductions that were similar to those observed in Westerners, except at lower statin doses. Low-intensity statins are not recommended in these guidelines for patients with T2D. Low-, moderate-, and high-intensity statins therapy are predicted to reduce plasma low-density lipoprotein cholesterol (LDL-C) levels from baseline by approximately <30%, 30% to <50%, and ≥50%, respectively. The American Diabetes Association 2016 guideline and the American College of Cardiology/American Heart Association 2013 guideline both recommended using moderate- and high-intensity statins in all T2D patients, except those aged <40 years without ASCVD risk factors. Statin treatment has been shown to be effective in reducing ASCVD events both in primary and secondary prevention. Type 2 diabetes (T2D) is an independent risk factor for atherosclerotic cardiovascular disease (ASCVD) and has been classified as coronary heart disease (CHD) risk equivalent. Due to the improved response to lower doses observed in Asians, a titration dosage strategy should be considered. Low- and moderate-intensity statins achieved plasma LDL-C goal of <100 mg/dl and <70 mg/dl in 84.3%, and 38.4% of the patients respectively. Factors associated with very favorable responses from statins were age, hypertension, patients with stable or reduced weight, and better glycemic control. LDL-C reductions ≥50% can be achieved in 38.4%. Plasma LDL-C goal of <100 mg/dl and <70 mg/dl was achieved in 84.3% and 38.0% respectively, with no significant difference between the low- and moderate-intensity statin users. Median duration of diabetes was 13.3 years and mean HbA1C was 8.1 ± 1.9%. Of the 400 patients, 41.3% were low-intensity statin users. Patients were classified into 1 of the following 2 groups according to their plasma LDL-C reductions by statins (N = 393) very favorable response (LDL-C reduction ≥50%) or less favorable response (LDL-C reduction <50%). T2D patients who were treated with low- and moderate-intensity statins at the Siriraj Diabetes Clinic during the January 2013 to December 2014 study period were eligible for inclusion(n = 978), 400 patients were randomly recruited. We aimed to assess the efficacy of low- and moderate-intensity statins for achieving plasma lipid targets in Thai type2 diabetes (T2D) and to evaluate factors associated with greater LDL-C reduction by statins. Low dose statins are commonly used among Asians, because plasma low-density lipoprotein cholesterol (LDL-C) reductions similar to those observed in Westerners are achieved at lower doses.
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