Diabetes Obes Metab:SGLT2抑制剂与DPP4抑制剂治疗患者心衰风险比较

2020-12-21 MedSci原创 MedSci原创

与使用DPP4抑制剂的老年人相比,使用SGLT2抑制剂的老年人心衰住院或死亡的发生率较低,且低血糖发生率较低,但糖尿病酮症酸中毒的发生率增加。

钠-葡萄糖同向转运体(SGLT2)抑制剂可降低中年人心衰的风险,这种益处是否也适用于老年人尚未明确。近日,代谢内分泌疾病领域权威杂志Diabetes Obesity & Metabolism上发表了一篇研究文章,这项研究旨在分析SGLT2抑制剂对老年人心力衰竭住院率的影响。

研究人员对2015年7月至2019年3月期间在加拿大安大略省接受SGLT2抑制剂或DPP4抑制剂治疗的65岁以上糖尿病成年人进行了一项队列研究。该研究的主要结局是心力衰竭住院和全因死亡率的综合结局,次要结局包括糖尿病酮症酸中毒和低血糖症。

研究人员将29916名服用SGLT2抑制剂的成年人与29916名服用DPP4抑制剂的成年人进行了比较。受试者平均年龄为72岁,男性为60%,基线血红蛋白A1C为8.2%,基线肌酐为89mmol/L。服用SGLT2抑制剂的成年人主要结局发生率为19/1000人每年,而服用DPP4抑制剂的成年人的主要结局发生率为38/1000人每年,其风险比(HR)为0.49,(95%置信区间(CI):0.45-0.54)。使用SGLT2抑制剂的患者低血糖发生率也较低(HR=0.61,95%CI为0.46-0.81);差异=-1.6(95%CI为-2.4,-0.8),但糖尿病酮症酸中毒发生率更高(HR=1.84,95%CI为1.26-2.70); 差异=1.0(95%CI为0.4-1.6)。

由此可见,与使用DPP4抑制剂的老年人相比,使用SGLT2抑制剂的老年人心衰住院或死亡的发生率较低,且低血糖发生率较低,但糖尿病酮症酸中毒的发生率增加
 
原始出处:
 
Michael Fralick.et al.SGLT2 inhibitors versus DPP4 inhibitors and the risk of heart failure: A nationwide cohort study of older adults with diabetes mellitus.Diabetes Obesity & Metabolism.2020.https://doi.org/10.1111/dom.14300

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    2021-11-04 guojianrong
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status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=921947, encodeId=ee0592194e86, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=89, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210131/b35591bafe2a4b869917b577adba9fab/c267322e38334bd6a95a8340ea85f70c.jpg, createdBy=f36b1426385, createdName=6322400001, createdTime=Mon Feb 01 15:37:59 CST 2021, time=2021-02-01, status=1, ipAttribution=)]
  5. [GetPortalCommentsPageByObjectIdResponse(id=1902535, encodeId=7b851902535b3, content=<a href='/topic/show?id=c097591ed5' target=_blank style='color:#2F92EE;'>#Diabetes#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5917, encryptionId=c097591ed5, topicName=Diabetes)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=0045169, createdName=木头人513, createdTime=Thu Oct 28 17:09:34 CST 2021, time=2021-10-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1888255, encodeId=18971888255c8, content=<a href='/topic/show?id=d56611584ec' target=_blank style='color:#2F92EE;'>#Meta#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=20, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11584, encryptionId=d56611584ec, topicName=Meta)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d8f4110, 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level=null, likeNumber=18, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=16217, encryptionId=5a3f1621e7d, topicName=SGLT)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=54f9127, createdName=tulenzi, createdTime=Thu Apr 08 23:09:34 CST 2021, time=2021-04-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1943590, encodeId=ee2f194359099, content=<a href='/topic/show?id=a0876221eb' target=_blank style='color:#2F92EE;'>#DPP4抑制剂#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=6221, encryptionId=a0876221eb, topicName=DPP4抑制剂)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=65c7309, createdName=fengxx, createdTime=Tue Sep 28 00:09:34 CST 2021, time=2021-09-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1896791, encodeId=1cfc1896e910d, content=<a href='/topic/show?id=4a391158248' target=_blank style='color:#2F92EE;'>#MET#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=21, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11582, encryptionId=4a391158248, topicName=MET)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=18fc139, createdName=一闲, createdTime=Wed Feb 10 02:09:34 CST 2021, time=2021-02-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1761564, encodeId=dc921e6156402, content=<a href='/topic/show?id=9bea33520d' target=_blank style='color:#2F92EE;'>#BET#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3352, encryptionId=9bea33520d, topicName=BET)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=9a1a37427546, createdName=ms5439512287675881, createdTime=Sun Mar 21 06:09:34 CST 2021, time=2021-03-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=921947, encodeId=ee0592194e86, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=89, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210131/b35591bafe2a4b869917b577adba9fab/c267322e38334bd6a95a8340ea85f70c.jpg, createdBy=f36b1426385, createdName=6322400001, createdTime=Mon Feb 01 15:37:59 CST 2021, time=2021-02-01, status=1, ipAttribution=)]
    2021-07-15 jklm09
  6. 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href='/topic/show?id=4a391158248' target=_blank style='color:#2F92EE;'>#MET#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=21, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11582, encryptionId=4a391158248, topicName=MET)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=18fc139, createdName=一闲, createdTime=Wed Feb 10 02:09:34 CST 2021, time=2021-02-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1761564, encodeId=dc921e6156402, content=<a href='/topic/show?id=9bea33520d' target=_blank style='color:#2F92EE;'>#BET#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3352, encryptionId=9bea33520d, topicName=BET)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=9a1a37427546, createdName=ms5439512287675881, createdTime=Sun Mar 21 06:09:34 CST 2021, time=2021-03-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=921947, encodeId=ee0592194e86, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=89, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210131/b35591bafe2a4b869917b577adba9fab/c267322e38334bd6a95a8340ea85f70c.jpg, createdBy=f36b1426385, createdName=6322400001, createdTime=Mon Feb 01 15:37:59 CST 2021, time=2021-02-01, status=1, ipAttribution=)]
    2021-04-08 tulenzi
  7. 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status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=921947, encodeId=ee0592194e86, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=89, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210131/b35591bafe2a4b869917b577adba9fab/c267322e38334bd6a95a8340ea85f70c.jpg, createdBy=f36b1426385, createdName=6322400001, createdTime=Mon Feb 01 15:37:59 CST 2021, time=2021-02-01, status=1, ipAttribution=)]
  8. 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status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=921947, encodeId=ee0592194e86, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=89, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210131/b35591bafe2a4b869917b577adba9fab/c267322e38334bd6a95a8340ea85f70c.jpg, createdBy=f36b1426385, createdName=6322400001, createdTime=Mon Feb 01 15:37:59 CST 2021, time=2021-02-01, status=1, ipAttribution=)]
    2021-02-10 一闲
  9. 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    2021-02-01 6322400001

    学习

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