Eur J Clin Invest:我国台湾学者发现,长期用胰岛素或增房颤风险,应用DPP4抑制剂则降低风险

2017-04-11 朱柳媛 中国循环杂志

既往研究表明,应用降糖药物与新发房颤有关。


既往研究表明,应用降糖药物与新发房颤有关。

近期,我国台湾学者一项巢式病例对照研究提示,在老年患者中,应用新型降糖药二肽基肽酶(DPP)4抑制剂者新发房颤的风险降低,而应用胰岛素的患者新发房颤的风险明显增加。

校正性别、年龄、合并症和合并用药等因素后,应用胰岛素的患者新发房颤的风险比不用胰岛素者增加58%,应用DPP4抑制剂者新发房颤的风险较不用这类药物者降低35%。

二甲双胍、阿卡波糖、格列奈类、磺脲类和噻唑烷二酮类降糖药物与新发房颤风险无关。

研究者指出,该研究首次发现DPP4抑制剂与房颤风险降低有关,具体原因尚不清楚,可能与应用这类药物的患者基线年龄相对较低以及合并症较少有关。

在这项研究中,胰岛素增加新发房颤风险,可能与应用胰岛素的患者病程超过8年以及血糖控制较差有关。

之前有研究发现,二甲双胍与新发房颤风险降低有关,这项研究却未得出这样的结果,可能与该研究中应用二甲双胍的患者年龄较高(75岁)有关。

这项研究从台湾健康保险项目中提取了2005-2012年1958例老年(65岁以上)新发房颤患者的数据,作为房颤组,而随机选择与之性别、年龄、糖尿病病程、用药时间、Charlson合并症指数评分均匹配的7832例无房颤老年人作为对照组。

原始出处:

Chen HY, Yang FY, Jong GP,et al.Antihyperglycemic Drugs Use and New-onset Atrial Fibrillation in Elderly Patients.Eur J Clin Invest. 2017 Mar 30.

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    2017-06-21 baoya
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    2018-01-02 jklm09
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    2017-04-13 oliver176
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    2017-04-12 tofsw

    学习了谢谢分享

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