Lancet Diabetes Endo:GLP-1激动剂对心血管事件、死亡率及肾脏事件的影响

2019-08-15 MedSci MedSci原创

研究发现,GLP-1受体激动剂治疗对II型糖尿病患者的心血管、死亡率和肾脏预后有益

不同的胰高血糖素样肽-1(GLP-1)受体激动剂对糖尿病患者心血管结果的影响存在差异。近日研究人员通过回顾和Meta分析考察GLP-1药物的心血管结局。

研究收集截至2019年6月15日相关研究,研究的主要终点为心血管不良事件(MACE;即心血管死亡、中风或心肌梗死)。研究采用随机效应模型进行了Meta分析,以估计MACE的总危险比(HRs)、其组成、任何原因的死亡、心力衰竭入院、肾脏结局和主要安全性结局(严重低血糖胰腺炎和胰腺癌)。研究人员还根据患者特征(心血管疾病史、BMI、年龄、基线HbA1c和基线估计肾小球滤过率)、试验持续时间、治疗给药间隔和结构同源性对几个亚组的MACE进行了检查。

7项试验,包括ELIXA(利司那肽)、LEADER(利拉鲁肽)、SUSTAIN-6(索马鲁肽)、EXSCEL(exenatide)、Harmony Outcomes(阿必鲁泰)、REWIND(杜拉鲁肽)和PIONEER6(口服索马鲁肽),共56004名参与者。总的来说,GLP1受体激动剂治疗将MACE降低12%(HR 0.88)。所有亚组均无统计学意义的异质性。心血管原因死亡风险为0.88,致命性或非致死性卒风险为0.84,致命性或非致命性心肌梗死风险为0.91。GLP1受体激动剂治疗将所有原因死亡率降低了12%,心衰住院治疗减少9%,广泛的复合肾脏结局(新发大量白蛋白尿、肾小球滤过率下降、进展至终末期肾病或因肾脏原因死亡) 减少17%,主要原因是尿白蛋白排泄减少。严重低血糖、胰腺炎或胰腺癌的风险没有增加。

研究发现,GLP-1受体激动剂治疗对II型糖尿病患者的心血管、死亡率和肾脏预后有益。

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    2019-09-15 liujie6118

    GLP-1受体激动剂治疗对II型糖尿病患者的心血管、死亡率和肾脏预后有益

    0

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    2020-05-10 howi
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    2019-08-17 yibei
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