在2型糖尿病中,与SGLT2抑制剂相关的红细胞和血栓栓塞风险
Yu-Han Chen1, Tina Yi Jin Hsieh2,3, Andrea Yue-En Sun4
1Department of Internal Medicine, Englewood Hospital and Medical Center, Englewood, NJ, USA.
Scientific reports
|December 10, 2025
概括
与其他疗法相比,在2型糖尿病患者中使用-葡萄糖共载体-2抑制剂 (SGLT2i) 并没有增加红细胞瘤的风险. 然而,SGLT2i使用者的红细胞瘤与更高的血栓栓塞事件风险相关.
科学领域:
- 内分泌学 在内分泌学.
- 心血管医学 心血管医学
- 血液学 血液学 血液学
背景情况:
- -葡萄糖共载体-2抑制剂 (SGLT2i) 越来越多地用于2型糖尿病的治疗.
- 需要调查SGLT2i治疗与红细胞瘤或血栓栓塞事件之间的潜在关联.
研究的目的:
- 为了评估SGLT2i使用SGLT2i的2型糖尿病患者的红细胞瘤和随后的动脉和静脉血栓的风险,与与葡萄糖类-1受体激活剂 (GLP1RA) 或二乙酶-4抑制剂 (DPP4i) 相比.
主要方法:
- 一项回顾性队列研究,涉及50多个美国医疗保健机构.
- 2型糖尿病患者在SGLT2i与GLP1RA或DPP4i之间进行的比较.
- 倾向性得分匹配和Cox比例危险回归来分析红细胞瘤和血栓栓塞事件.
主要成果:
- 在男性和女性患者中,DPP4i和GLP1RA的使用与SGLT2i使用相比,与显著更高的红细胞瘤风险有关.
- 与DPP4i用户相比,SGLT2i用户的心血管事件较少,但女性中风/TIA增加.
- 与GLP1RA相比,SGLT2i使用与MACE降低有关,但其他血管事件的风险更高.
- 在SGLT2i使用者的红细胞瘤与增加的血栓栓塞事件相关.
- 在接受治疗的红细胞结核病患者中,停止SGLT2i增加了男性中风/TIA,MI和四肢缺血的风险,以及女性中风/TIA,MI和静脉血栓的风险.
结论:
- 与DPP4i或GLP1RA相比,SGLT2i治疗与红细胞瘤的风险增加无关.
- 使用SGLT2i的患者的红细胞瘤与更高的血栓栓塞事件发生率有关.
- 建议SGLT2i用户定期监测血液学参数,并考虑修改治疗策略,以减轻并发症风险.
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