在2型糖尿病中预防痴呆症的SGLT2is与甲福明对比:一个现实世界的头对头比较研究
Mingyang Sun1, Xiaoling Wang1,2, Zhongyuan Lu1,2
1Department of Anesthesiology and Perioperative Medicine, People's Hospital of Zhengzhou University, Henan Provincial People's Hospital, Zhengzhou, Henan, China.
Diabetes care
|May 28, 2025
概括
与甲相比,-葡萄糖携带载体2抑制剂 (SGLT2is) 在2型糖尿病患者中显著降低了妄想风险. 此外,SGLT2还降低了死亡率,特别是在老年人和高危人群中.
科学领域:
- 内分泌学 在内分泌学.
- 老年病的医生 老年病的医生
- 药理学 药理学是指药理学的学科.
背景情况:
- 2型糖尿病 (T2D) 与认知衰退和妄想的风险增加有关.
- 甲胺是一种常见的T2D的第一线治疗方法,但其对妄想的作用尚未完全理解.
- -葡萄糖共运输体2抑制剂 (SGLT2is) 是一种较新的抗糖尿病药物类别,除了降低葡萄糖之外,它还具有潜在的性作用.
研究的目的:
- 使用真实世界的数据,比较SGLT2抑制剂与甲福明在预防T2D患者发生狂妄症方面的有效性.
- 作为次要结果,评估这些药物的对全因死亡率的影响.
主要方法:
- 使用TriNetX全球健康研究网络进行了一项回顾性队列研究.
- 包括857171名患有T2D的成年人,他们开始服用SGLT2i或甲福林.
- 倾向性得分匹配 (1:1) 用于平衡基线特征,然后对妄发病率和全因死亡率进行分析.
主要成果:
- 与甲福明相比,SGLT2i启动与妄的风险显著降低 (aHR 0.91;P < 0.001).
- 在SGLT2i组中,全因死亡率也显著降低 (aHR 0.85;P < 0.001).
- 在80岁以上的成年人,男性和接受胰岛素或镇静剂的高危子组中,SGLT2is对妄的保护作用最为明显.
结论:
- 在现实世界中,SGLT2抑制剂在患有T2D的患者中,与甲福明相比,对狂妄表现出更好的保护.
- 这些发现表明,在糖尿病治疗决策中应该考虑认知结果.
- 这些结果可能支持对T2D的第一线治疗策略的转变,优先考虑具有潜在神经保护益处的药物.
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