Diabetes Care:初始DPP4I增加老年人急性胰腺炎风险吗?

2018-06-28 吴星 环球医学

2018年6月,美国学者在《Diabetes Care》发表了美国老年人亚组差异假设的检验,考察了初始二肽基肽酶4抑制剂(DPP4I)后的急性胰腺炎风险。

2018年6月,美国学者在《Diabetes Care》发表了美国老年人亚组差异假设的检验,考察了初始二肽基肽酶4抑制剂(DPP4I)后的急性胰腺炎风险。

目的:考察DPP4I是否会增加老年患者急性胰腺炎风险,以及该相关性是否因年龄、性别和心血管疾病(CVD)史而具有差异。

研究设计和方法:研究者使用2007~2014年美国Medicare受益人数据进行了一项DPP4I初始者vs噻唑烷二酮(TZD)或磺脲类药物初始者的队列研究。入组标准为,≥66岁,无胰腺疾病史或酒精相关疾病史。对因急性胰腺炎住院的患者进行随访,并在治疗改变后90天进行审查。加权Cox模型用于评估急性胰腺炎的风险比(HR)。进行整体分析和性别、年龄、CVD史的亚组分析。

结果:与132223名磺脲类初始者相比,49374名DPP4I初始者的急性胰腺炎风险未增加(加权HR,1.01;95% CI,0.83~1.24)。与32612名TZD初始者相比,57301名DPP4I初始者的急性胰腺炎风险未增加(加权HR,1.11;95% CI,0.76~1.62)。年龄和性别不改变此相关性。CVD患者中,初始DPP4I和磺脲类药物的患者急性胰腺炎发病率增加(分别为2.3和2.4/1000人-年),但TZD初始者未增加(1.5)。CVD患者中,与TZD相比(加权HR,1.84;95% CI,1.02~3.35),DPP4I的急性胰腺炎风险更高,而与磺脲类药物相比则无该相关性。

结论:本研究提供证据显示,DPP4I与整体老年人急性胰腺炎风险增加不相关。在CVD患者中观察到的该正相关性可能由机会或偏倚造成,但值得进一步研究。

原始出处:

Hong JL, Buse JB, Jonsson Funk M, et.al. The Risk of Acute Pancreatitis After Initiation of Dipeptidyl Peptidase 4 Inhibitors: Testing a Hypothesis of Subgroup Differences in Older U.S. Adults. Diabetes Care. 2018 Jun;41(6):1196-1203. doi: 10.2337/dc17-2212. Epub 2018 Apr 4.

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    2018-07-01 1e145228m78(暂无匿称)

    学习了.谢谢作者分享!

    0

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    2018-06-30 秀红

    学习了

    0

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    2018-06-30 oliver176
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    2018-06-28 1ddf0692m34(暂无匿称)

    学习了.谢谢分享

    0

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