常规类固醇与双释放皮对代谢,心血管和骨缺陷的结果:一项为期10年的研究
Valentina Guarnotta1, Claudia Di Stefano1, Laura Tomasello1
1Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, Section of Endocrinology, University of Palermo, Piazza delle Cliniche 2, 90127 Palermo, Italy.
European journal of endocrinology
|August 22, 2024
概括
常规的葡萄糖皮质激素 (GC) 治疗上腺功能不全 (AI) 恶化代谢和心血管健康超过10年. 每日补充皮激素 (DR-HC) 提供了一个更安全的替代方案,保护患者的健康结果.
科学领域:
- 内分泌学 在内分泌学.
- 代谢研究的研究.
- 心血管健康的心血管健康
背景情况:
- 上腺功能衰竭 (AI) 与较高的死亡率有关,主要来自心血管疾病.
- 传统的葡萄糖皮质体 (GC) 替代疗法可能会导致死亡风险增加.
- 了解不同GC疗法的长期影响对于患者管理至关重要.
研究的目的:
- 为了比较传统的GC与每日补充皮 (DR-HC) 对未经治疗的AI患者体重的10年影响.
- 为了评估10年来人类,代谢,心血管和骨健康的变化.
- 评估不同葡萄糖皮质体替代策略的长期安全性和有效性.
主要方法:
- 预期随机试验涉及86名未经治疗的AI患者.
- 患者被分配给传统的GC (皮质醇酸盐或皮质醇) 或DR-HC (1:1比).
- 人类测量,代谢,心血管和骨参数的全面评估在基线,5年和10年进行.
主要成果:
- 传统的GC治疗导致10年后BMI,腰围和缩血压显著增加.
- 接受常规GCs的患者表现出脂质特征 (总和LDL胆固醇) 和血糖控制 (HbA1c,HOMA-IR,AUC2h葡萄糖) 的恶化.
- 心脏参数 (心室间隔膜厚度) 和骨密度 (腰椎T-score,大腿Z-score) 受到传统GC的负面影响,与DR-HC不同.
结论:
- 在AI患者中,十年的传统GC治疗与不良的代谢,心血管和骨健康结果有关.
- DR-HC疗法对这些参数产生中性影响,表明并发症风险降低.
- 在AI中,DR-HC成为长期葡萄糖皮质类药物替代的潜在更安全的替代方案.
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