与补充剂和口服双酸盐相互作用相关的缺血性中风风险:一个嵌套的病例对照研究
Diana Barreira-Hernández1, Sara Rodríguez-Martín1, Miguel Gil2
1Department of Biomedical Sciences (Pharmacology), University of Alcalá (IRYCIS), 28805 Alcalá de Henares, Spain.
Journal of clinical medicine
|August 26, 2023
概括
补充剂 (CS) 单独增加心血管缺血性中风 (IS) 风险,特别是口服双酸盐 (oBs). 与维生素D (CaD) 没有显著的IS风险. 这凸显了与特定补充剂组合相关的风险.
科学领域:
- 心血管流行病学心血管流行病学
- 药物监督 药物监督 药物监督
- 营养科学 营养科学
背景情况:
- 关于补充剂 (CS) 和缺血性中风 (IS) 之间的关联存在相互矛盾的证据.
- 之前的研究并没有在单独的 (CaM) 和含有维生素D的 (CaD) 之间以及心血管和非心血管IS亚型之间进行一致的区分.
- 在中风风险上,CS和口服双酸盐 (oBs) 之间的潜在相互作用仍未得到充分研究.
研究的目的:
- 研究补充剂 (CaM和CaD) 与缺血性中风 (IS) 风险之间的关联,区分心血管和非心血管亚型.
- 检查同时使用补充剂和口服双酸盐 (oBs) 对IS风险的潜在相互作用效应.
- 为了澄清关于补充的使用和中风风险的相互矛盾的发现.
主要方法:
- 采用了一个嵌套的病例控制研究设计,包括40-90岁的事件IS病例和随机抽样对照,根据年龄,性别和索引日期进行匹配.
- 条件后勤回归被用来计算调整的赔率比率 (AOR) 和95%置信区间 (CI) 对于现有用户与非用户,重点是新用户.
- 这项研究分析了13,267例IS病例 (4400例心血管,8867例非心血管) 和61,378例对照病例.
主要成果:
- 单独使用 (CaM) 与心血管栓塞综合征的风险增加显著相关 (AOR = 1.88),风险随使用时间增加而增加,但与非心血管栓塞综合征 (AOR = 1.05) 无关.
- 同时使用CaM和口服双酸盐 (oBs) 显著增加了心血管栓塞综合征的风险 (AOR = 2.54),但对非心血管栓塞综合征没有影响.
- 与维生素D (CaD) 的使用与任何IS亚型都没有关联,尽管与oBs (AOR = 1.35) 结合时观察到与心血管性IS的小关联.
结论:
- 这些发现支持了补充 (CS) 的假设,特别是单独的 (CaM),增加了心血管栓塞性缺血性中风 (IS) 的风险.
- 与CS相关的心血管栓塞性IS的风险在与口服双酸盐 (oBs) 同时使用时显著放大.
- 与维生素D (CaD) 似乎具有不同的风险概况,与IS的联系有限,即使与oBs结合.
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