関連する実験動画
スタチンと発症糖尿病のリスク:スタチンのランダム化試験の共同メタ解析
Naveed Sattar1, David Preiss, Heather M Murray
1British Heart Foundation Glasgow Cardiovascular Research Centre, University of Glasgow, Glasgow, UK. nsattar@clinmed.gla.ac.uk
Lancet (London, England)
|February 20, 2010
まとめ
スタチンの治療は,糖尿病のリスクを9%わずかに増加させるが,絶対リスクは低いままである. この発見は,心血管疾患患者の臨床実務の変更を正当化するものではありません.
科学分野:
- 心血管医学 心血管医学
- エンドクリノロジー エンドクリノロジー
- 薬理学 薬理学とは
背景:
- スタチン療法と新規発症糖尿病に関して,相反する試験データが存在します.
- スタチンの使用と糖尿病の発症の関係を解明するためにメタアナリシスが行われました.
研究 の 目的:
- スタチンの使用と発生糖尿病に関する公表および未公表のデータをメタ分析する.
- スタチン療法に関連する糖尿病を発症するリスクを定量化するために.
主な方法:
- Medline,Embase,およびコクラン・セントラル・レジスター・オブ・コントローラド・トライアル (1994-2009) の体系的な検索
- 含有基準:ランダム化対照試験 >1000名,期間 >1年,フォローアップは同一であった.
- ランダム効果メタ解析で,異質性を評価するためにI(2) 統計を用いた.
主要な成果:
- 91,140人の参加者を含む13件の試験を分析し,4278人が糖尿病を発症した.
- スタチンの治療は,低異質性 (I(2) =11%で,インシデント糖尿病 (OR 1.09; 95% CI 1.02-1.17) のリスクが9%増加したことを示しました.
- リスクは年配の参加者において最も高かった;ベースラインのBMIとLDLコレステロールの変化は残留リスクを説明しなかった.
結論:
- スタチンの治療は,糖尿病リスクのわずかな増加と関連しており,絶対値では低いです.
- 冠動脈事件の減少におけるスタチンの利点は,この小さなリスクを上回ります.
- 中程度の/高い心血管リスクまたは既存の心血管疾患を有する患者の臨床実践は変わらずに留まるべきです.
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