相关实验视频
类药物和发生糖尿病的风险:对随机化类药物试验的协作元分析
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
概括
静止剂治疗略微增加了9%的糖尿病风险,但绝对风险仍然很低. 这一发现不需要改变心血管病患者的临床实践.
科学领域:
- 心血管医学 心血管医学
- 内分泌学 在内分泌学.
- 药理学 药理学是指药理学的学科.
背景情况:
- 关于他类药物治疗和新发型糖尿病的试验数据存在矛盾.
- 进行了一项元分析,以澄清他类药物使用与糖尿病发展之间的关系.
研究的目的:
- 对已发表和未发表的关于他类药物使用和发生糖尿病的数据进行元分析.
- 量化与他类药物治疗相关的糖尿病发病风险.
主要方法:
- 对Medline,Embase和Cochrane控制试验中央注册 (1994-2009) 的系统搜索.
- 纳入标准:随机对照试验>1000名患者,持续时间>1年,跟踪情况相同.
- 随机效应元分析使用I(2) 统计来评估异质性.
主要成果:
- 分析了13项与91,140名参与者的试验; 4,278人患上了糖尿病.
- 立方体治疗显示发生糖尿病的风险增加了9% (OR 1.09;95% CI 1.02-1.17) 与低异质性 (I(2) =11%).
- 老年参与者的风险最高;基线BMI和LDL胆固醇变化无法解释残留风险.
结论:
- 类固醇药物治疗与糖尿病风险的小幅增加有关,绝对来说,这种风险很低.
- 对于降低冠状动脉事件,他类药物的益处超过了这种小风险.
- 对于中度/高心血管风险或现有的心血管疾病患者的临床实践应该保持不变.
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