有糖尿病,多大剂量的阿托伐他汀防心梗更有效?BMJ杂志Meta分析

2022-03-28 中国循环杂志 网络

高强度辛伐他汀和瑞舒伐他汀治疗对于降低LDL-C最有效。

研究发现,对于糖尿病患者来说,他汀是降低冠心病风险的最有效药物。

3月24日,《英国医学杂志(BMJ)》发表的一项Meta分析提示,对于糖尿病患者,在降低非高密度脂蛋白胆固醇(HDL-C)降低方面,在7种常用的他汀中,中高强度剂量(5~40 mg)瑞舒伐他汀、高强度剂量的辛伐他汀(20~40 mg)和阿托伐他汀(40~80 mg)最有效。

而在二级预防人群中,高强度剂量的阿托伐他汀最有效。

与安慰剂相比,中等强度(10~20 mg)阿托伐他汀可显著降低非致死性心梗,降幅为43%。

高强度辛伐他汀和瑞舒伐他汀治疗对于降低LDL-C最有效,可将LDL-C水平分别降低1.93 mmol/L和1.76 mmol/L。

作者指出,与LDL-C相比,非HDL-C可更有力地预测心血管病,现在已成为降胆固醇治疗降低心血管风险的主要靶标。该研究对于最有效降低糖尿病患者非HDL-C的他汀类型和强度,提供了指导信息。

研究者共搜集到42项随机对照研究(包括20 193例成年糖尿病患者),最终纳入11 698例患者进行Meta分析。

 

参考文献:

Comparative effectiveness of statins on non-high density lipoprotein cholesterol in people with diabetes and at risk of cardiovascular disease: systematic review and network meta-analysis. BMJ, 2022, 376: e067731.

版权声明:
本网站所有内容来源注明为“梅斯医学”或“MedSci原创”的文字、图片和音视频资料,版权均属于梅斯医学所有。非经授权,任何媒体、网站或个人不得转载,授权转载时须注明来源为“梅斯医学”。其它来源的文章系转载文章,或“梅斯号”自媒体发布的文章,仅系出于传递更多信息之目的,本站仅负责审核内容合规,其内容不代表本站立场,本站不负责内容的准确性和版权。如果存在侵权、或不希望被转载的媒体或个人可与我们联系,我们将立即进行删除处理。
在此留言
评论区 (5)
#插入话题
  1. [GetPortalCommentsPageByObjectIdResponse(id=1888423, encodeId=27571888423e9, content=<a href='/topic/show?id=d56611584ec' target=_blank style='color:#2F92EE;'>#Meta#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=44, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11584, encryptionId=d56611584ec, topicName=Meta)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d8f4110, createdName=guojianrong, createdTime=Thu Mar 02 20:30:04 CST 2023, time=2023-03-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1896996, encodeId=4eaf189699668, content=<a href='/topic/show?id=4a391158248' target=_blank style='color:#2F92EE;'>#MET#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=43, 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=Tue May 31 18:30:04 CST 2022, time=2022-05-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1237129, encodeId=0b22123e1292f, content=超级感谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=62, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210127/50a003c4097845e182c08afd64d8a509/bd766dfebe9c40e0bca2dae964601bdc.jpg, createdBy=22de5454917, createdName=carrotlyl, createdTime=Sun Aug 07 18:30:15 CST 2022, time=2022-08-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1849395, encodeId=17761849395e8, content=<a href='/topic/show?id=2977356edc' target=_blank style='color:#2F92EE;'>#BMJ#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=46, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3567, encryptionId=2977356edc, topicName=BMJ)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=148754, createdName=gaoxiaoe, createdTime=Mon Sep 19 02:30:04 CST 2022, time=2022-09-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1578711, encodeId=634d15e87115c, content=<a href='/topic/show?id=fbf0436148a' target=_blank style='color:#2F92EE;'>#大剂量#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=48, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=43614, encryptionId=fbf0436148a, topicName=大剂量)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=cd6a16418535, createdName=ms7899726347904398, createdTime=Wed Mar 30 00:30:04 CST 2022, time=2022-03-30, status=1, ipAttribution=)]
    2023-03-02 guojianrong
  2. [GetPortalCommentsPageByObjectIdResponse(id=1888423, encodeId=27571888423e9, content=<a href='/topic/show?id=d56611584ec' target=_blank style='color:#2F92EE;'>#Meta#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=44, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11584, encryptionId=d56611584ec, topicName=Meta)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d8f4110, createdName=guojianrong, createdTime=Thu Mar 02 20:30:04 CST 2023, time=2023-03-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1896996, encodeId=4eaf189699668, content=<a href='/topic/show?id=4a391158248' target=_blank style='color:#2F92EE;'>#MET#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=43, 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=Tue May 31 18:30:04 CST 2022, time=2022-05-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1237129, encodeId=0b22123e1292f, content=超级感谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=62, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210127/50a003c4097845e182c08afd64d8a509/bd766dfebe9c40e0bca2dae964601bdc.jpg, createdBy=22de5454917, createdName=carrotlyl, createdTime=Sun Aug 07 18:30:15 CST 2022, time=2022-08-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1849395, encodeId=17761849395e8, content=<a href='/topic/show?id=2977356edc' target=_blank style='color:#2F92EE;'>#BMJ#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=46, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3567, encryptionId=2977356edc, topicName=BMJ)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=148754, createdName=gaoxiaoe, createdTime=Mon Sep 19 02:30:04 CST 2022, time=2022-09-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1578711, encodeId=634d15e87115c, content=<a href='/topic/show?id=fbf0436148a' target=_blank style='color:#2F92EE;'>#大剂量#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=48, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=43614, encryptionId=fbf0436148a, topicName=大剂量)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=cd6a16418535, createdName=ms7899726347904398, createdTime=Wed Mar 30 00:30:04 CST 2022, time=2022-03-30, status=1, ipAttribution=)]
    2022-05-31 一闲
  3. [GetPortalCommentsPageByObjectIdResponse(id=1888423, encodeId=27571888423e9, content=<a href='/topic/show?id=d56611584ec' target=_blank style='color:#2F92EE;'>#Meta#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=44, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11584, encryptionId=d56611584ec, topicName=Meta)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d8f4110, createdName=guojianrong, createdTime=Thu Mar 02 20:30:04 CST 2023, time=2023-03-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1896996, encodeId=4eaf189699668, content=<a href='/topic/show?id=4a391158248' target=_blank style='color:#2F92EE;'>#MET#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=43, 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=Tue May 31 18:30:04 CST 2022, time=2022-05-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1237129, encodeId=0b22123e1292f, content=超级感谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=62, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210127/50a003c4097845e182c08afd64d8a509/bd766dfebe9c40e0bca2dae964601bdc.jpg, createdBy=22de5454917, createdName=carrotlyl, createdTime=Sun Aug 07 18:30:15 CST 2022, time=2022-08-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1849395, encodeId=17761849395e8, content=<a href='/topic/show?id=2977356edc' target=_blank style='color:#2F92EE;'>#BMJ#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=46, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3567, encryptionId=2977356edc, topicName=BMJ)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=148754, createdName=gaoxiaoe, createdTime=Mon Sep 19 02:30:04 CST 2022, time=2022-09-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1578711, encodeId=634d15e87115c, content=<a href='/topic/show?id=fbf0436148a' target=_blank style='color:#2F92EE;'>#大剂量#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=48, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=43614, encryptionId=fbf0436148a, topicName=大剂量)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=cd6a16418535, createdName=ms7899726347904398, createdTime=Wed Mar 30 00:30:04 CST 2022, time=2022-03-30, status=1, ipAttribution=)]
    2022-08-07 carrotlyl

    超级感谢分享

    0

  4. [GetPortalCommentsPageByObjectIdResponse(id=1888423, encodeId=27571888423e9, content=<a href='/topic/show?id=d56611584ec' target=_blank style='color:#2F92EE;'>#Meta#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=44, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11584, encryptionId=d56611584ec, topicName=Meta)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d8f4110, createdName=guojianrong, createdTime=Thu Mar 02 20:30:04 CST 2023, time=2023-03-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1896996, encodeId=4eaf189699668, content=<a href='/topic/show?id=4a391158248' target=_blank style='color:#2F92EE;'>#MET#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=43, 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=Tue May 31 18:30:04 CST 2022, time=2022-05-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1237129, encodeId=0b22123e1292f, content=超级感谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=62, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210127/50a003c4097845e182c08afd64d8a509/bd766dfebe9c40e0bca2dae964601bdc.jpg, createdBy=22de5454917, createdName=carrotlyl, createdTime=Sun Aug 07 18:30:15 CST 2022, time=2022-08-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1849395, encodeId=17761849395e8, content=<a href='/topic/show?id=2977356edc' target=_blank style='color:#2F92EE;'>#BMJ#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=46, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3567, encryptionId=2977356edc, topicName=BMJ)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=148754, createdName=gaoxiaoe, createdTime=Mon Sep 19 02:30:04 CST 2022, time=2022-09-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1578711, encodeId=634d15e87115c, content=<a href='/topic/show?id=fbf0436148a' target=_blank style='color:#2F92EE;'>#大剂量#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=48, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=43614, encryptionId=fbf0436148a, topicName=大剂量)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=cd6a16418535, createdName=ms7899726347904398, createdTime=Wed Mar 30 00:30:04 CST 2022, time=2022-03-30, status=1, ipAttribution=)]
    2022-09-19 gaoxiaoe
  5. [GetPortalCommentsPageByObjectIdResponse(id=1888423, encodeId=27571888423e9, content=<a href='/topic/show?id=d56611584ec' target=_blank style='color:#2F92EE;'>#Meta#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=44, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11584, encryptionId=d56611584ec, topicName=Meta)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d8f4110, createdName=guojianrong, createdTime=Thu Mar 02 20:30:04 CST 2023, time=2023-03-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1896996, encodeId=4eaf189699668, content=<a href='/topic/show?id=4a391158248' target=_blank style='color:#2F92EE;'>#MET#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=43, 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=Tue May 31 18:30:04 CST 2022, time=2022-05-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1237129, encodeId=0b22123e1292f, content=超级感谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=62, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210127/50a003c4097845e182c08afd64d8a509/bd766dfebe9c40e0bca2dae964601bdc.jpg, createdBy=22de5454917, createdName=carrotlyl, createdTime=Sun Aug 07 18:30:15 CST 2022, time=2022-08-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1849395, encodeId=17761849395e8, content=<a href='/topic/show?id=2977356edc' target=_blank style='color:#2F92EE;'>#BMJ#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=46, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3567, encryptionId=2977356edc, topicName=BMJ)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=148754, createdName=gaoxiaoe, createdTime=Mon Sep 19 02:30:04 CST 2022, time=2022-09-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1578711, encodeId=634d15e87115c, content=<a href='/topic/show?id=fbf0436148a' target=_blank style='color:#2F92EE;'>#大剂量#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=48, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=43614, encryptionId=fbf0436148a, topicName=大剂量)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=cd6a16418535, createdName=ms7899726347904398, createdTime=Wed Mar 30 00:30:04 CST 2022, time=2022-03-30, status=1, ipAttribution=)]

相关资讯

Nature Communications:仅喝3个月酸奶,促进代谢健康,降低糖尿病风险

糖尿病是一种慢性疾病,影响全球超过4.6亿人。随着生活和饮食习惯的改变,糖尿病已经成为继心脑血管疾病、恶性肿瘤之后影响人类健康的第三大因素。在中国,成年人有超过1.14亿糖尿病患者,占全世界糖尿病患者

PLoS Biol:脂类风险评分可以预测糖尿病和心血管疾病的发病率

正如世界卫生组织(WHO)定期报告的那样,心血管疾病和糖尿病是全球十大主要死亡原因之一。患心血管疾病和2型糖尿病(T2D)的风险与饮食和其他与生活方式有关的行为有关。

哈佛大规模随机试验:晚饭吃太晚,造成胰岛素分泌缺陷,增加糖尿病风险!

相比18:00吃晚餐的志愿者,22:00吃晚餐的志愿者机体葡萄糖峰值水平会升高大约18%,其整夜燃烧脂肪的量会下降10%。

JDR:参连汤通过调节db/db小鼠的肠道菌群来改善血糖

从调节肠道菌群的角度来揭示参连汤抗糖尿病的机制。

多不饱和脂肪酸好处多多?谁吃&吃谁都有讲究!还可升高2型糖尿病风险!

Diabetol Metab Syndr.:成人多不饱和脂肪酸摄入和2型糖尿病的发病率:队列研究的剂量反应荟萃分析

柳叶刀:超1000万人研究数据表明,新冠患者确诊1年后糖尿病风险激增40%!且感染越重风险越高...

研究表明,在疾病的急性后阶段,COVID-19患者表现出糖尿病和抗高血糖药物使用的风险和负担增加。