Ann Intern Med：钠-葡萄糖协同转运蛋白-2抑制剂与二甲双胍治疗2型糖尿病患者的心血管结局比较

2022-05-30 MedSci原创 MedSci原创

作为一线T2D治疗，与接受二甲双胍的患者相比，接受SGLT-2i的患者出现MI/卒中/死亡率的风险相似，HHF/死亡率和HHF的风险较低，且安全性相当，但生殖器感染风险增加。

与二甲双胍相比，钠-葡萄糖协同转运蛋白-2抑制剂(SGLT-2i)与心血管事件相关的风险证据十分有限。近日，内科学权威杂志Annals of Internal Medicine上发表了一篇研究文章，该研究旨在评估使用SGLT-2i与二甲双胍进行治疗的2型糖尿病(T2D)成人的心血管结局。

该研究以人群为基础的队列研究，采用了美国两大商业和医疗保险数据库的索赔数据(2013年4月至2020年3月)。该研究的参与者为18岁及以上的T2D患者在2013年4月至2020年3月期间开始使用SGLT-2i或二甲双胍治疗，他们在进入队列前未使用任何降糖药物。在每个数据库中进行1:2倾向评分匹配后，报告了汇总风险比(HRs)和95%CI。该研究的主要结局是心肌梗死住院、缺血性或出血性卒中住院或全因死亡率(MI/卒中/死亡率)住院、心力衰竭住院或全因死亡率(HHF/死亡率)住院的复合结局，研究人员评估了包括生殖器感染在内的安全性结局。

在8613名SGLT-2i服用者与17226名二甲双胍服用者匹配；平均随访12个月，与二甲双胍服用者相比，SGLT-2i服用者发生心肌梗死/卒中/死亡的风险相似(HR为0.96;95%CI为0.77-1.19)， HHF/死亡率风险较低(HR为0.80;95%CI为0.66-0.97)。与二甲双胍相比，SGLT-2i服用者发生HHF的风险较低(HR为0.78;95%CI为0.63-0.97)，MI风险较低(HR为0.70;95%CI为0.48-1.00)，而卒中、死亡率和MI/卒中/HHF/死亡率的风险相似。SGLT-2i服用者发生生殖器感染的风险更高(HR为2.19;95%CI为1.91-2.51)，而安全性与二甲双胍组相似。

由此可见，作为一线T2D治疗，与接受二甲双胍的患者相比，接受SGLT-2i的患者出现MI/卒中/死亡率的风险相似，HHF/死亡率和HHF的风险较低，且安全性相当，但生殖器感染风险增加。

原始出处：

HoJin Shin, BPharm,et al. Cardiovascular Outcomes in Patients Initiating First-Line Treatment of Type 2 Diabetes With Sodium–Glucose Cotransporter-2 Inhibitors Versus Metformin A Cohort Study.Ann Intern Med 2022.https://www.acpjournals.org/doi/10.7326/M21-4012

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2022-11-16 yzh409

#转运#

45 0
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2023-03-21 jklm09

#抑制剂#

53 0
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2022-11-22 jklm19

#钠-葡萄糖协同转运蛋白-2抑制剂#

38 0
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2022-08-29 liuquan

#2抑制剂#

65 0
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2022-05-31 gous

#心血管结局#

74 0
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2022-05-31 aids213

#2型糖尿病患者#

29 0
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2022-05-31 xue8604

#糖尿病患者#

43 0
[GetPortalCommentsPageByObjectIdResponse(id=1696378, encodeId=39fa16963e87e, content=<a href='/topic/show?id=0107934e0a5' target=_blank style='color:#2F92EE;'>#转运#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=93470, encryptionId=0107934e0a5, topicName=转运)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=47c429881595, createdName=yzh409, createdTime=Wed Nov 16 04:53:34 CST 2022, time=2022-11-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1852984, encodeId=cb0a185298405, 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=53, 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=Tue Mar 21 07:53:34 CST 2023, time=2023-03-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1691566, encodeId=d19516915667b, content=<a href='/topic/show?id=d3349643968' target=_blank style='color:#2F92EE;'>#钠-葡萄糖协同转运蛋白-2抑制剂#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=96439, encryptionId=d3349643968, topicName=钠-葡萄糖协同转运蛋白-2抑制剂)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=5c9529239665, createdName=jklm19, createdTime=Tue Nov 22 05:53:34 CST 2022, time=2022-11-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1995666, encodeId=9f441995666bd, content=<a href='/topic/show?id=992411149e' target=_blank style='color:#2F92EE;'>#2抑制剂#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=65, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=1114, encryptionId=992411149e, topicName=2抑制剂)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=28b7142, createdName=liuquan, createdTime=Mon Aug 29 06:53:34 CST 2022, time=2022-08-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1269405, encodeId=ea9d1269405dc, content=<a href='/topic/show?id=49d1518915a' target=_blank style='color:#2F92EE;'>#心血管结局#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=74, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=51891, encryptionId=49d1518915a, topicName=心血管结局)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7a9987, createdName=gous, createdTime=Tue May 31 08:53:34 CST 2022, time=2022-05-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1383789, encodeId=46ca1383e8941, content=<a href='/topic/show?id=196a1101f7' target=_blank style='color:#2F92EE;'>#2型糖尿病患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=1101, encryptionId=196a1101f7, topicName=2型糖尿病患者)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ec19483, createdName=aids213, createdTime=Tue May 31 08:53:34 CST 2022, time=2022-05-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1475278, encodeId=3e3014e52780e, content=<a href='/topic/show?id=935fe6718e3' target=_blank style='color:#2F92EE;'>#糖尿病患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=43, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=76718, encryptionId=935fe6718e3, topicName=糖尿病患者)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a38f7243741, createdName=xue8604, createdTime=Tue May 31 08:53:34 CST 2022, time=2022-05-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1611608, encodeId=c7171611608b3, content=<a href='/topic/show?id=eb6b1145939' target=_blank style='color:#2F92EE;'>#Med#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11459, encryptionId=eb6b1145939, topicName=Med)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=552a19396740, createdName=ms3994565386320060, createdTime=Tue May 31 08:53:34 CST 2022, time=2022-05-31, status=1, ipAttribution=)]
2022-05-31 ms3994565386320060

#Med#

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Ann Intern Med：钠-葡萄糖协同转运蛋白-2抑制剂与二甲双胍治疗2型糖尿病患者的心血管结局比较

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