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在他类药物治疗期间与发生糖尿病相关的心血管结果:全国性倾向匹配队列研究
Ki-Chul Sung1, Dongwoo Kang2, Jungkuk Lee2
1Division of Cardiology, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, 29 Saemunan-Ro, Jongno-Gu, Seoul, 03181, Republic of Korea. kcmd.sung@samsung.com.
Cardiovascular diabetology
|December 25, 2025
概括
在他类药物治疗期间新发型2型糖尿病与在糖尿病诊断后开始服用他类药物相比,较大心血管不良事件 (MACE) 的风险较低. 这一发现表明,他类药物诱导的糖尿病可能不会增加心血管风险.
科学领域:
- 心脏病学 心脏病学
- 内分泌学 在内分泌学.
- 公共卫生 公共卫生
背景情况:
- 类药物对于预防心血管疾病至关重要.
- 新出现的证据将他类药物的使用与新发型2型糖尿病联系起来.
- 对于他类药物相关糖尿病的心血管影响尚不清楚.
研究的目的:
- 调查在他类药物治疗期间发生的糖尿病和主要不良心血管事件 (MACE) 之间的关联.
- 为了比较糖尿病发病的他类药物使用者的心血管结果,与那些先前患有糖尿病或保持无糖尿病的人相比.
主要方法:
- 两项回顾性队列研究利用了韩国国家健康保险服务 (KNHIS) 数据库 (2009-2020年).
- 研究1: 4371名新发型2型糖尿病 (T2DM) 的他类药物使用者与在T2DM诊断后开始治疗的他类药物使用者进行倾向评分匹配.
- 研究2: 4191名开发T2DM的他类药物使用者与保持无糖尿病的他类药物使用者进行了匹配. 评估了MACE (心肌梗塞,中风) 和所有原因死亡率.
主要成果:
- 在第1研究中,与开始使用他类药物后糖尿病诊断 (aHR 0.607;P=.0005) 相比,在他类药物治疗期间发生糖尿病的风险显著降低,由中风风险降低 (aHR 0.504;P<.001) 驱动.
- 在研究2中,在使用他类药物时发生的糖尿病与与保持无糖尿病相比,没有增加MACE风险 (aHR 1.122; P=.53) 或全因死亡率 (aHR 0.555; P=.0758).
结论:
- 在他类药物治疗期间发展的糖尿病与MACE的风险较低,与在糖尿病诊断后开始服用他类药物相比.
- 在使用他类药物期间发生糖尿病似乎不会增加MACE或所有原因死亡的风险,而不是与未患糖尿病的患者相比.
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