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与中剂量他类药物治疗相比,高剂量糖尿病发病风险:一个元分析
David Preiss1, Sreenivasa Rao Kondapally Seshasai, Paul Welsh
1BHF Glasgow Cardiovascular Research Centre, University of Glasgow, 126 University Pl, Glasgow G12 8TA, Scotland, United Kingdom. david.preiss@glasgow.ac.uk
JAMA
|June 23, 2011
概括
与中剂量治疗相比,高剂量他类药物治疗增加了12%的新发糖尿病的风险. 然而,它也可以减少16%的心血管事件.
科学领域:
- 心脏病学 心脏病学
- 代谢障碍 代谢障碍 代谢障碍
- 临床试验 临床试验
背景情况:
- 类固醇药物治疗与糖尿病风险增加有关.
- 以前的元分析表明,他类药物和糖尿病发展之间存在潜在的关联.
研究的目的:
- 为了比较强剂量和中剂量他类药物治疗之间的新发糖尿病风险.
- 评估高剂量他类药物治疗与中剂量治疗对心血管的益处.
主要方法:
- 进行了对5项随机对照试验的元分析.
- 包括的试验比较了强剂量与中剂量他类药物治疗在1000多名参与者跟踪超过1年.
- 用随机效应模型提取和分析了新发糖尿病和主要心血管事件的数据.
主要成果:
- 高剂量他类药物治疗与12%的新发糖尿病风险增加有关 (OR 1.12;95% CI,1.04-1.22).
- 对于新发型糖尿病来说,每年需要伤害的数量是498个.
- 强剂量他类药物治疗显示,主要心血管事件减少了16% (OR 0.84;95% CI,0.75-0.94).
- 治疗心血管事件所需的人数为每年155人.
结论:
- 与中剂量治疗相比,高剂量他类药物治疗与新发糖尿病的风险更高.
- 尽管糖尿病风险增加,但高剂量的他类药物提供了显著的心血管益处.
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