{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T17:22:37Z","timestamp":1785172957767,"version":"3.55.0"},"reference-count":24,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,6,11]],"date-time":"2026-06-11T00:00:00Z","timestamp":1781136000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,6,11]],"date-time":"2026-06-11T00:00:00Z","timestamp":1781136000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Diabetes Metabolism Res"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>The purpose of this paper is to compare the risk of incident type 2 diabetes mellitus (T2DM) among patients with hyperlipidaemia treated with proprotein convertase subtilisin\/kexin type 9 (PCSK9) inhibitors versus statins and other nonstatin lipid\u2010lowering agents.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and Results<\/jats:title>\n                    <jats:p>This target trial emulation study used a retrospective, propensity score\u2013matched cohort design based on the TriNetX Global Collaborative Network. Adults (\u2265\u00a018\u00a0years) with hyperlipidaemia diagnosed between January 2015 and December 2024 were included. Patients with preexisting diabetes, malignancy, or death during follow\u2010up were excluded. Three active\u2010comparator analyses compared PCSK9 inhibitors with statins, ezetimibe and fenofibrates under a per\u2010protocol framework. Propensity score matching (1:1) balanced demographics, comorbidities, BMI, lipid profiles and healthcare utilization. Incident T2DM was identified using ICD\u201010 codes and analysed. Multiple sensitivity analyses including intention\u2010to\u2010treat analysis were performed. In the main analysis model, PCSK9 inhibitor use was associated with a significantly lower risk of incident T2DM than statins (HR 0.815; 95% CI 0.764\u20130.869), ezetimibe (HR 0.919, 95% CI 0.867\u20130.974), and fenofibrates (HR 0.517; 95% CI 0.493\u20130.542). Findings were consistent across subgroups and sensitivity analyses. No significant difference was observed between different PCSK9 inhibitor modalities.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In this large\u2010scale real\u2010world cohort, PCSK9 inhibitors were associated with a lower risk of new\u2010onset T2DM compared with other lipid\u2010lowering therapies, supporting their metabolic safety and clinical use in patients at risk for diabetes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/dmrr.70188","type":"journal-article","created":{"date-parts":[[2026,6,11]],"date-time":"2026-06-11T13:26:00Z","timestamp":1781184360000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Lower Risk of Type 2 Diabetes Mellitus With PCSK9 Inhibitors Compared With Other Lipid\u2010Lowering Agents Among Patients With Hyperlipidaemia"],"prefix":"10.1002","volume":"42","author":[{"given":"Jiun\u2010Lu","family":"Lin","sequence":"first","affiliation":[{"name":"Division of Endocrinology and Metabolism Department of Internal Medicine MacKay Memorial Hospital  Taipei Taiwan"},{"name":"Department of Medicine MacKay Medical University  New Taipei City Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christine","family":"Hsu","sequence":"additional","affiliation":[{"name":"Department of Medicine Monmouth Medical Center Robert Wood Johnson\/Barnabas Health Care System  Long Branch New Jersey USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shao\u2010Wei","family":"Lo","sequence":"additional","affiliation":[{"name":"Department of Medicine Cleveland Clinic Foundation  Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nishtha","family":"Nigam","sequence":"additional","affiliation":[{"name":"Department of Medicine Monmouth Medical Center Robert Wood Johnson\/Barnabas Health Care System  Long Branch New Jersey USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mahima","family":"Shenoi","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Rochester General Hospital  Rochester New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yung\u2010Fang","family":"Tu","sequence":"additional","affiliation":[{"name":"Department of Biostatistics Harvard T.H. Chan School of Public Health  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hardikkumar","family":"Bhanderi","sequence":"additional","affiliation":[{"name":"Department of Medicine Monmouth Medical Center Robert Wood Johnson\/Barnabas Health Care System  Long Branch New Jersey USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9599-0884","authenticated-orcid":false,"given":"Chien\u2010Chin","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Pathology Ditmanson Medical Foundation Chia\u2010Yi Christian Hospital  Chiayi Taiwan"},{"name":"Department of Cosmetic Science Chia Nan University of Pharmacy and Science  Tainan Taiwan"},{"name":"Ph.D. Program in Translational Medicine Rong Hsing Research Center for Translational Medicine National Chung Hsing University  Taichung Taiwan"},{"name":"Department of Biotechnology and Bioindustry Sciences College of Bioscience and Biotechnology National Cheng Kung University  Tainan Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu\u2010Jung","family":"Su","sequence":"additional","affiliation":[{"name":"Orthopedics Department Chi\u2010Mei Medical Center  Tainan Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-4135-6742","authenticated-orcid":false,"given":"Hui\u2010Chin","family":"Chang","sequence":"additional","affiliation":[{"name":"Evidence\u2010Based Medicine Center Chung Shan Medical University Hospital  Taichung Taiwan"},{"name":"Library Chung Shan Medical University\u00a0Hospital  Taichung Taiwan"},{"name":"School of Medicine Chung Shan Medical University  Taichung Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8897-5635","authenticated-orcid":false,"given":"Shuo\u2010Yan","family":"Gau","sequence":"additional","affiliation":[{"name":"Institute of Allergology 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