《柳叶刀》子刊:新型降脂药PCSK9抑制剂可能也轻度升高血糖

2016-12-29 朱朱 中国循环杂志

作为使用最为广泛的降脂药物,他汀能显著降低低密度脂蛋白胆固醇(LDL-C)以及冠心病风险,但也有轻度升高血糖的风险。当然,与其显著的临床获益比较来说,这种风险微不足道。 近期在《柳叶刀·糖尿病与内分泌学》上公布的一项孟德尔随机研究提示,目前研究大热的降脂药物——PCSK9(前蛋白转化酶枯草溶菌素9)抑制剂可能也有升高空腹血糖和增加体重的风险。 研究人员发现,4个独立的PCSK9变异基因(rs115

作为使用最为广泛的降脂药物,他汀能显著降低低密度脂蛋白胆固醇(LDL-C)以及冠心病风险,但也有轻度升高血糖的风险。当然,与其显著的临床获益比较来说,这种风险微不足道。

近期在《柳叶刀·糖尿病与内分泌学》上公布的一项孟德尔随机研究提示,目前研究大热的降脂药物——PCSK9(前蛋白转化酶枯草溶菌素9)抑制剂可能也有升高空腹血糖和增加体重的风险。

研究人员发现,4个独立的PCSK9变异基因(rs11583680、rs11591147、rs2479409和rs11206510)每使LDL-C降低1 mmol/L,空腹血糖会升高0.09 mmol/L,体重增加1.03 kg,腰臀比增加0.006,糖尿病风险升高29%。

研究人员指出,在PCSK9抑制剂临床研究中,要仔细评估空腹血糖、体重、腰臀比以及糖尿病等安全性终点,并应像研究他汀一样,权衡这类新型降脂药物的获益和风险。

这项研究获取了5万余例2型糖尿病患者和55万例正常人的数据。

目前,已有两种PCSK9抑制剂即Praluent(alirocumab)和Repatha(evolocumab)获得美国及欧盟批准,用于家族性高胆固醇血症、LDL-C未达标患者、不能耐受他汀类药物的心血管病高危患者。

原始出处:


Schmidt AF, Swerdlow DI, Holmes MV, et al. PCSK9genetic variants and risk of type 2 diabetes: a mendelian randomisation study.Lancet Diabetes Endocrinol. 2016 Nov 28.

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    2017-02-16 jklm09
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    2017-08-28 FukaiBao
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    2016-12-31 Boyinsh
  6. [GetPortalCommentsPageByObjectIdResponse(id=1851381, encodeId=b1c91851381de, content=<a href='/topic/show?id=f0a254918f0' target=_blank style='color:#2F92EE;'>#抑制剂#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=54918, encryptionId=f0a254918f0, topicName=抑制剂)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=44a360, createdName=jklm09, createdTime=Thu Feb 16 17:26:00 CST 2017, time=2017-02-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1777243, encodeId=1e7b1e77243c7, content=<a href='/topic/show?id=678d5348a6' target=_blank style='color:#2F92EE;'>#Csk#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=41, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5348, encryptionId=678d5348a6, topicName=Csk)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=979839152460, createdName=FukaiBao, createdTime=Mon Aug 28 16:26:00 CST 2017, time=2017-08-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1786850, encodeId=e2711e86850e5, content=<a href='/topic/show?id=4c5b138824d' target=_blank style='color:#2F92EE;'>#PCSK9抑制#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=13882, encryptionId=4c5b138824d, topicName=PCSK9抑制)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1072181, createdName=wjywjy, createdTime=Tue Apr 18 22:26:00 CST 2017, time=2017-04-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1261093, encodeId=041c12610938e, content=<a href='/topic/show?id=30c6102e2607' target=_blank style='color:#2F92EE;'>#高血糖#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=102726, encryptionId=30c6102e2607, topicName=高血糖)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=hb2008ye, createdTime=Sat Dec 31 02:26:00 CST 2016, time=2016-12-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1348376, encodeId=45e213483e650, content=<a href='/topic/show?id=9f7198199df' target=_blank style='color:#2F92EE;'>#降脂药#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=98199, encryptionId=9f7198199df, topicName=降脂药)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=726030, createdName=Boyinsh, createdTime=Sat Dec 31 02:26:00 CST 2016, time=2016-12-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1685585, encodeId=ee7f168558576, content=<a href='/topic/show?id=a340138e48a' target=_blank style='color:#2F92EE;'>#PCS#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=13874, encryptionId=a340138e48a, topicName=PCS)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=173d28230918, createdName=Tamikia, createdTime=Tue Jul 11 07:26:00 CST 2017, time=2017-07-11, status=1, ipAttribution=)]
    2017-07-11 Tamikia

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