肥胖药物在末期脏疾病中的使用以及与移植列表的关联
Babak J Orandi1,2, Yiting Li1, Timur Seckin1
1Department of Surgery, New York University Grossman School of Medicine, New York, New York, USA.
Clinical transplantation
|August 21, 2024
概括
肥胖药物在末期病 (ESKD) 患者中很常见,特别是那些患有肥胖症的人. 它们的使用与更高的BMI和减少移植上市的几率有关,这表明应该考虑替代药物.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學.
- 药理学 药理学是指药理学的学科.
- 公共卫生 公共卫生
背景情况:
- 肥胖药物有助于一般成人人口的肥胖流行病.
- 这些药物在末期病 (ESKD) 患者的患病率和影响尚不清楚.
- 患有ESKD的患者患有心脏代谢并发症的风险更高,并且可能面临重量管理方面的挑战,以获得移植资格.
研究的目的:
- 确定接受血液透析的ESKD患者中服用肥胖原药的比例.
- 调查肥胖药物使用与体重指数 (BMI) 之间的关联.
- 为了检查肥胖药物使用与被列入移植名单的可能性之间的关系.
主要方法:
- 利用了2017-2020年对血液透析患者的USRDS和医疗保险索赔数据.
- 已识别的肥胖药物 (抗,抗抑郁药,抗糖尿病药,抗炎药,抗精神病药,抗高血压药) 处方时间≥30天.
- 使用顺序逻辑和考克斯回归与治疗权重的逆概率来分析与BMI和移植列表的关联.
主要成果:
- 在271,401名血液透析初学者中,63.5%的人至少服用了一种肥胖药物,BMI较高的人患病率更高.
- 每种额外的肥胖药物都与更高BMI的几率增加有关 (例如,三种药物增加了55%的几率).
- 任何使用肥胖药物的可能性都与移植上市的可能性降低了6%,这一趋势在所有BMI类别中观察到.
结论:
- 肥胖药物的使用在ESKD患者中非常普遍,特别是那些肥胖患者.
- 这些药物与BMI增加和脏移植上榜的可能性降低有关.
- 建议优先考虑ESKD患者的非肥胖替代品,旨在减肥和移植清单.
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