关于抗糖尿病药物和不良周产期结果之间的因果关系的新见解:孟德尔的随机化研究
Chang Su1, Xueqing He1, Xiaona Chang1
1Department of Endocrinology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China.
Diabetes & metabolism journal
|June 2, 2025
概括
大多数抗糖尿病药物在围产期使用似乎是安全的,SGLT2抑制剂可以减少早产和发育不良. 然而,GLP-1类似物可能会增加低出生体重的风险, thiazolidinediones可能会降低胎儿妊娠年龄.
科学领域:
- 药物基因组学 药物基因组学
- 孕产妇和胎儿医学 孕产妇和胎儿医学
- 药品安全 药品安全
背景情况:
- 孕期高血糖会增加不良周产期结果和出生缺陷的风险.
- 关于怀孕期间抗糖尿病药物的长期安全性的数据有限.
研究的目的:
- 调查六种抗糖尿病药物类别的遗传标与不良围产/先天性形结果之间的因果关系.
- 通过使用孟德尔的随机化方法来评估在怀孕期间常用的抗糖尿病药物的安全性.
主要方法:
- 采用了一个双样本的门德尔随机化研究设计.
- 与六种抗糖尿病药物标 (ABCC8,DPP4,INSR,GLP1R,PPARG,SLC5A2) 相关的遗传变异被分析为七种围产期和五种先天性形结局.
- 逆方差加权 (IVW) 分析是主要方法,对强度进行敏感性分析.
主要成果:
- -葡萄糖共运输体2 (SGLT2) 抑制剂显示,早产和心脏循环形的风险降低.
- 硫氨酸urea和 thiazolidinedione 药物标与减少黄昏症/孕前黄昏症的风险有关.
- 类似于葡萄糖类-1 (GLP-1) 的类似物与胎儿出生体重的反向关联, thiazolidinediones与妊娠年龄的减少有关.
结论:
- 大多数抗糖尿病药物在围产期使用可能是安全的.
- 特定药物类别需要谨慎使用:GLP-1类似物可能与较低的出生体重有关, thiazolidinediones可能与较短的胎儿妊娠年龄有关.
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