JAHA:磺脲类和二甲双胍单药治疗对心力衰竭风险的影响!

2017-04-23 xing.T MedSci原创

由此可见,与服用二甲双胍的患者相比,以磺脲类药物为主治疗糖尿病的男性患者发生心衰和心血管死亡风险更高。

影响胰岛素敏感性或引起体重增加的药物可能会增加心衰风险。近日,心血管疾病领域权威杂志JAHA上发表了一篇研究文章,研究人员旨在比较开始服用磺脲类药物和二甲双胍治疗的糖尿病患者之间心衰和心血管死亡的结局。

国家退伍军人健康管理数据库与医疗保险、医疗补助和国家死亡指数数据相链接。研究人员将年龄超过18岁的在2001年至2011年期间接受二甲双胍或磺脲类药物治疗并且其肌酐<1.4(女性)或1.5(男性)毫克/分升的患者被纳入研究。每个服用二甲双胍的患者通过倾向评分匹配服用磺脲类药物的患者。

该研究的结局为急性失代偿性心力衰竭住院,其是入院或心血管死亡的主要原因。研究人员发现分别有126867名二甲双胍和79192名磺酰脲药物服用者。倾向评分匹配产生了65985个组。这些患者的中位年龄为66岁,男性患者占97%,糖化血红蛋白为6.9%(6.3-7.7),体重指数为30.7公斤/平方米(27.4-34.6),6%的患者有心力衰竭史。在服用磺脲类药物组发生了1236次事件(1184次心衰住院和52次心血管死亡),在二甲双胍组发生了1078次事件(1043次心衰住院和35次心血管死亡)。每1000人每年使用二甲双胍和磺脲类药物分别有12.4次 vs. 8.9次事件,调整后的风险比为1.32,95%可信区间为1.21-1.43)。使用二甲双胍和磺脲类药物组每年发生心衰住院或心血管死亡的发生率差异为4次每1000人。

由此可见,与服用二甲双胍的患者相比,以磺脲类药物为主治疗糖尿病的男性患者发生心衰和心血管死亡风险更高。

原始出处:


Christianne L. Roumie,et al. Comparative Safety of Sulfonylurea and Metformin Monotherapy on the Risk of Heart Failure: A Cohort Study.JAHA.2017. https://doi.org/10.1161/JAHA.116.005379

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    2017-05-13 阿吴

    学习了

    0

  4. [GetPortalCommentsPageByObjectIdResponse(id=1797852, encodeId=5e741e97852e0, content=<a href='/topic/show?id=2b572398e58' target=_blank style='color:#2F92EE;'>#二甲双胍单药#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=23987, encryptionId=2b572398e58, topicName=二甲双胍单药)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a691420, createdName=30397604, createdTime=Wed Sep 27 12:06:00 CST 2017, time=2017-09-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1687697, encodeId=e591168e697df, content=<a href='/topic/show?id=be223633375' target=_blank style='color:#2F92EE;'>#单药治疗#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=36333, encryptionId=be223633375, topicName=单药治疗)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=2bef28414326, createdName=12498717m75(暂无昵称), createdTime=Wed Dec 27 16:06:00 CST 2017, time=2017-12-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=197637, encodeId=bcef19e637ac, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=63, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6KcicAVC1MwuGx0Nj1tUEG8bCiclXBNCCfjGSeFLCtppUMLTdyCtkvyjxxXViaDnQv43w5VAuic6FGPuCicSgnNKBc3/0, createdBy=21f41994764, createdName=阿吴, createdTime=Sat May 13 18:55:03 CST 2017, time=2017-05-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=195383, encodeId=bee8195383c7, content=学习了,谢谢, beContent=null, objectType=article, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=28761705280, createdName=cuiyejia, createdTime=Mon May 08 11:42:23 CST 2017, time=2017-05-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=194036, encodeId=5d2419403648, content=学习了,谢谢, beContent=null, objectType=article, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://q.qlogo.cn/qqapp/101296147/1A51842815047D40BFDAA8D69AA8E519/100, createdBy=fd7f2029163, createdName=绛珠草小姐, createdTime=Fri May 05 08:11:14 CST 2017, time=2017-05-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=192868, encodeId=a0c4192868d7, content=学习了,谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=79, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://q.qlogo.cn/qqapp/101296147/1A51842815047D40BFDAA8D69AA8E519/100, createdBy=fd7f2029163, createdName=绛珠草小姐, createdTime=Tue May 02 12:24:44 CST 2017, time=2017-05-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=191825, encodeId=2a72191825c9, content=学习了,谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=72, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://q.qlogo.cn/qqapp/101296147/1A51842815047D40BFDAA8D69AA8E519/100, createdBy=fd7f2029163, createdName=绛珠草小姐, createdTime=Sat Apr 29 12:52:50 CST 2017, time=2017-04-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=191168, encodeId=6d561911688d, content=学习了,谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=14, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://q.qlogo.cn/qqapp/101296147/1A51842815047D40BFDAA8D69AA8E519/100, createdBy=fd7f2029163, createdName=绛珠草小姐, createdTime=Thu Apr 27 17:27:39 CST 2017, time=2017-04-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=190875, encodeId=f6501908e52c, content=效果和风险并存!!, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=eff51996281, createdName=1e1b8538m79(暂无匿称), createdTime=Wed Apr 26 22:55:49 CST 2017, time=2017-04-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=190568, encodeId=c51d1905682d, content=又学习到了不错的知识, beContent=null, objectType=article, channel=null, level=null, likeNumber=17, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=eff51996281, createdName=1e1b8538m79(暂无匿称), createdTime=Tue Apr 25 23:26:40 CST 2017, time=2017-04-25, status=1, ipAttribution=)]
    2017-05-08 cuiyejia

    学习了,谢谢

    0

  5. [GetPortalCommentsPageByObjectIdResponse(id=1797852, encodeId=5e741e97852e0, content=<a href='/topic/show?id=2b572398e58' target=_blank style='color:#2F92EE;'>#二甲双胍单药#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=23987, encryptionId=2b572398e58, topicName=二甲双胍单药)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a691420, createdName=30397604, createdTime=Wed Sep 27 12:06:00 CST 2017, time=2017-09-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1687697, encodeId=e591168e697df, content=<a href='/topic/show?id=be223633375' target=_blank style='color:#2F92EE;'>#单药治疗#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=36333, encryptionId=be223633375, topicName=单药治疗)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=2bef28414326, createdName=12498717m75(暂无昵称), createdTime=Wed Dec 27 16:06:00 CST 2017, time=2017-12-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=197637, encodeId=bcef19e637ac, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=63, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6KcicAVC1MwuGx0Nj1tUEG8bCiclXBNCCfjGSeFLCtppUMLTdyCtkvyjxxXViaDnQv43w5VAuic6FGPuCicSgnNKBc3/0, createdBy=21f41994764, createdName=阿吴, createdTime=Sat May 13 18:55:03 CST 2017, time=2017-05-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=195383, encodeId=bee8195383c7, content=学习了,谢谢, beContent=null, objectType=article, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=28761705280, createdName=cuiyejia, createdTime=Mon May 08 11:42:23 CST 2017, time=2017-05-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=194036, encodeId=5d2419403648, content=学习了,谢谢, beContent=null, objectType=article, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://q.qlogo.cn/qqapp/101296147/1A51842815047D40BFDAA8D69AA8E519/100, createdBy=fd7f2029163, createdName=绛珠草小姐, createdTime=Fri May 05 08:11:14 CST 2017, time=2017-05-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=192868, encodeId=a0c4192868d7, content=学习了,谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=79, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://q.qlogo.cn/qqapp/101296147/1A51842815047D40BFDAA8D69AA8E519/100, createdBy=fd7f2029163, createdName=绛珠草小姐, createdTime=Tue May 02 12:24:44 CST 2017, time=2017-05-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=191825, encodeId=2a72191825c9, content=学习了,谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=72, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://q.qlogo.cn/qqapp/101296147/1A51842815047D40BFDAA8D69AA8E519/100, createdBy=fd7f2029163, createdName=绛珠草小姐, createdTime=Sat Apr 29 12:52:50 CST 2017, time=2017-04-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=191168, encodeId=6d561911688d, content=学习了,谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=14, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://q.qlogo.cn/qqapp/101296147/1A51842815047D40BFDAA8D69AA8E519/100, createdBy=fd7f2029163, createdName=绛珠草小姐, createdTime=Thu Apr 27 17:27:39 CST 2017, time=2017-04-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=190875, encodeId=f6501908e52c, content=效果和风险并存!!, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=eff51996281, createdName=1e1b8538m79(暂无匿称), createdTime=Wed Apr 26 22:55:49 CST 2017, time=2017-04-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=190568, encodeId=c51d1905682d, content=又学习到了不错的知识, beContent=null, objectType=article, channel=null, level=null, likeNumber=17, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=eff51996281, createdName=1e1b8538m79(暂无匿称), createdTime=Tue Apr 25 23:26:40 CST 2017, time=2017-04-25, status=1, ipAttribution=)]
    2017-05-05 绛珠草小姐

    学习了,谢谢

    0

  6. [GetPortalCommentsPageByObjectIdResponse(id=1797852, encodeId=5e741e97852e0, content=<a href='/topic/show?id=2b572398e58' target=_blank style='color:#2F92EE;'>#二甲双胍单药#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=23987, encryptionId=2b572398e58, topicName=二甲双胍单药)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a691420, createdName=30397604, createdTime=Wed Sep 27 12:06:00 CST 2017, time=2017-09-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1687697, encodeId=e591168e697df, content=<a href='/topic/show?id=be223633375' target=_blank style='color:#2F92EE;'>#单药治疗#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=36333, encryptionId=be223633375, topicName=单药治疗)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=2bef28414326, createdName=12498717m75(暂无昵称), createdTime=Wed Dec 27 16:06:00 CST 2017, time=2017-12-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=197637, encodeId=bcef19e637ac, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=63, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6KcicAVC1MwuGx0Nj1tUEG8bCiclXBNCCfjGSeFLCtppUMLTdyCtkvyjxxXViaDnQv43w5VAuic6FGPuCicSgnNKBc3/0, createdBy=21f41994764, createdName=阿吴, createdTime=Sat May 13 18:55:03 CST 2017, time=2017-05-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=195383, encodeId=bee8195383c7, content=学习了,谢谢, beContent=null, objectType=article, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=28761705280, createdName=cuiyejia, createdTime=Mon May 08 11:42:23 CST 2017, time=2017-05-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=194036, encodeId=5d2419403648, content=学习了,谢谢, beContent=null, objectType=article, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://q.qlogo.cn/qqapp/101296147/1A51842815047D40BFDAA8D69AA8E519/100, createdBy=fd7f2029163, createdName=绛珠草小姐, createdTime=Fri May 05 08:11:14 CST 2017, time=2017-05-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=192868, encodeId=a0c4192868d7, content=学习了,谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=79, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://q.qlogo.cn/qqapp/101296147/1A51842815047D40BFDAA8D69AA8E519/100, createdBy=fd7f2029163, createdName=绛珠草小姐, createdTime=Tue May 02 12:24:44 CST 2017, time=2017-05-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=191825, encodeId=2a72191825c9, content=学习了,谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=72, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://q.qlogo.cn/qqapp/101296147/1A51842815047D40BFDAA8D69AA8E519/100, createdBy=fd7f2029163, createdName=绛珠草小姐, createdTime=Sat Apr 29 12:52:50 CST 2017, time=2017-04-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=191168, encodeId=6d561911688d, content=学习了,谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=14, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://q.qlogo.cn/qqapp/101296147/1A51842815047D40BFDAA8D69AA8E519/100, createdBy=fd7f2029163, createdName=绛珠草小姐, createdTime=Thu Apr 27 17:27:39 CST 2017, time=2017-04-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=190875, encodeId=f6501908e52c, content=效果和风险并存!!, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=eff51996281, createdName=1e1b8538m79(暂无匿称), createdTime=Wed Apr 26 22:55:49 CST 2017, time=2017-04-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=190568, encodeId=c51d1905682d, content=又学习到了不错的知识, beContent=null, objectType=article, channel=null, level=null, likeNumber=17, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=eff51996281, createdName=1e1b8538m79(暂无匿称), createdTime=Tue Apr 25 23:26:40 CST 2017, time=2017-04-25, status=1, ipAttribution=)]
    2017-05-02 绛珠草小姐

    学习了,谢谢分享

    0

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    2017-04-29 绛珠草小姐

    学习了,谢谢分享

    0

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    2017-04-27 绛珠草小姐

    学习了,谢谢分享

    0

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    2017-04-26 1e1b8538m79(暂无匿称)

    效果和风险并存!!

    0

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    2017-04-25 1e1b8538m79(暂无匿称)

    又学习到了不错的知识

    0

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