在接受GLP-1受体激活剂治疗的2型糖尿病患者中,现实世界的性别差异
Sara Piccini1, Giuseppe Favacchio1, Emanuela Morenghi2
1Endocrinology, Diabetology and Andrology Unit, IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089 Rozzano, Milan, Italy.
Diabetes research and clinical practice
|May 2, 2024
概括
对葡萄糖类-1受体激动剂 (GLP1-RA) 的心血管保护在男性和女性中显示出类似的主要心血管不良事件 (MACE) 发生率. 然而,MACE的风险因素因性别而异.
科学领域:
- 心脏病学 心脏病学
- 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:
- 葡萄糖类-1受体激动剂 (GLP1-RA) 越来越多地用于管理2型糖尿病和心血管风险.
- 了解GLP1-RA对心血管 (CV) 保护的性别特异性决定因素对于个性化治疗策略至关重要.
研究的目的:
- 评估与葡萄糖类-1受体激活剂 (GLP1-RA) 治疗的患者心血管保护的性别特异性决定因素.
- 在接受GLP1-RA治疗的男性和女性中确定影响主要不良心血管事件 (MACE) 的因素.
主要方法:
- 追溯队列研究涉及550名患者 (43%为女性),接受GLP1-RA治疗.
- 与患者人口统计,临床因素和GLP1-RA治疗持续时间相关的重大心血管不良事件 (MACE) 的分析.
- 分层分析以比较男性和女性之间MACE的决定因素,考虑初级预防和二级预防队列.
主要成果:
- 总的来说,MACE的发生率在两性之间是可比的.
- 在初级预防中,男性MACE风险与老年和GLP1-RA退出有关. 女性MACE风险与糖尿病持续时间,GLP1-RA戒断和戒断时的BMI有关.
- 在二次预防中,男性的MACE风险与GLP1-RA退出有关,而女性的MACE风险与GLP1-RA开始时的年龄有关.
结论:
- 虽然MACE的发病率在两性之间是相似的,但心血管风险的基本决定因素不同.
- 性别特定的因素影响GLP1-RA在预防MACE的有效性,突出显示了需要量身定制的治疗方法.
- 在初级和二级预防中,GLP1-RA撤销成为男性MACE的常见风险因素,这强调了治疗坚持的重要性.
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