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SGLT2抑制剂对艾滋病毒感染者功能的影响:美国前性多站点研究
Lara Haidar1, Heidi M Crane2, Robin M Nance2
1University of Manitoba, Winnipeg, Manitoba, Canada.
Journal of acquired immune deficiency syndromes (1999)
|February 24, 2026
概括
-葡萄糖共运输体2抑制剂 (SGLT2i) 在艾滋病毒感染者 (PWH) 中导致临时早期EGFR下降. 这种最初的下降是小的和短暂的,类似于一般人群,尽管使用SGLT2i的PWH的发病率更高.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學.
- 传染病 (艾滋病毒/艾滋病)
- 药理学 药理学是指药理学的学科.
背景情况:
- -葡萄糖共运输体2抑制剂 (SGLT2i) 已知能保护脏,但可能导致早期估计的球透率 (eGFR) 降低,称为"eGFR下降".
- 这种现象在艾滋病毒感染者 (PWH) 中未得到充分研究,他们患病的风险较高.
研究的目的:
- 与其他抗高血糖药物相比,研究启动SGLT2i的PWH早期eGFR下降的发生率和程度.
- 通过SGLT2i.使用PWH分析24个月的长期eGFR趋势.
主要方法:
- 通过使用9个艾滋病研究中心综合临床系统网络 (CNICS) 站点的数据,进行了1:1倾向分数匹配的队列研究.
- 新的SGLT2i用户与其他抗高血糖类的新用户进行了比较.
- 针对eGFR下降的调整危险比率 (aHRs) (≥10%和≥30%) 和对eGFR变化的多变量线性混合模型被使用. 使用局部加权分散图平滑 (LOWESS) 曲线可视化了更长期的趋势.
主要成果:
- 在295个匹配的PWH对中,SGLT2i用户在6个月内显示出≥10%的eGFR下降 (58.2%对37.4%;aHR: 1.79) 和≥30%的eGFR下降 (17.3%对9.8%;aHR: 1.69) 的更高发病率.
- 在6个月后,SGLT2i用户的调整平均eGFR变化为-2.62mL/min/1.73m2,而其他类别的0.05mL/min/1.73m2.
- 长期分析显示,在SGLT2i启动后,EGFR初始下降,随后稳定,与其他抗高血糖类相比,下降速度更慢.
结论:
- 与其他抗高血糖药物相比,PWH启动SGLT2i的急性EGFR下降更频繁.
- 然而,这些下降是小的,短暂的,并且与一般人口的发现一致.
- 需要进一步的研究,以充分了解SGLT2i在PWH中的长期效应.
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