Rheumatology:吡格列酮可降低糖尿病患者痛风的发病率

2018-01-25 吴星 环球医学

2018年1月,发表在《Rheumatology (Oxford)》的一项由中国台湾和美国科学家进行的研究表明,吡格列酮可降低糖尿病患者痛风的发病率。

2018年1月,发表在《Rheumatology (Oxford)》的一项由中国台湾和美国科学家进行的研究表明,吡格列酮可降低糖尿病患者痛风的发病率。

痛风的发病率和患病率正在增加,但管理较差。鉴于糖尿病人群中痛风发病率增加,本研究评价了胰岛素抵抗抑制剂——吡格列酮对糖尿病人群痛风发病率的影响。

研究人员使用来自中国台湾地区健康保险项目中的数据。吡格列酮队列包含30100例患者,将每例患者按照年龄和性别,与从糖尿病人群中随机挑选出的3名非吡格列酮使用者进行匹配。进行Cox比例风险回归分析,以估算吡格列酮对糖尿病人群痛风发病率的影响。

结果显示吡格列酮使用者的痛风发病率显著低于非吡格列酮使用者[校正风险比(aHR)0.81(95% CI 0.78,0.85)]。吡格列酮男性[aHR 0.80(95% CI 0.75,0.85)]和女性[aHR 0.83(95% CI 0.78,0.88)]使用者的痛风发病HR均低于非吡格列酮使用者。3个年龄组的分析(<40岁、40~59岁和≥60岁)显示,吡格列酮使用者中40~59岁组[aHR 0.78(95% CI 0.73,0.83)]和≥60岁组[aHR 0.85(95% CI 0.80,0.91)]的HRs均显著低于非吡格列酮使用者。

由此可见,与非吡格列酮使用者相比,使用吡格列酮的糖尿病人群中痛风发病率更低。

原始出处:

Niu SW, Chang KT, Lin HY, et.al. Decreased incidence of gout in diabetic patients using pioglitazone. Rheumatology (Oxford). 2018 Jan 1;57

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    2018-01-25 龙胆草

    学习谢谢分享

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    2018-01-25 小树熊

    学习了.谢谢

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J Diabetes Investig:吡格列酮对脂肪萎缩的糖尿病影响有限

近期,发表于《糖尿病调查》上的文章指出,对于由于幼年皮肌炎引起的脂肪缺乏型糖尿病患者,吡格列酮虽然有轻微改善肝功能的作用,但是并不能有效的降低血糖水平。

JAMA N:卒中二级预防,吡格列酮对高风险者更加有效

缺血性卒中或TIA处于脑血管和心血管事件复发的高风险之中。目前预防是唯一有效的方法,包括抗血小板药物、颈动脉血运重建、抗凝、控制血压、降脂。2016年IRIS试验发现在标准二级预防的基础上增加吡格列酮(胰岛素增敏剂)能够把卒中或心肌梗死的风险再降低24%。虽然耐受性较好,但是吡格列酮会增加体重、引起外周水肿以及增加骨折的风险。因此,临床医师使用吡格列酮时应该仔细衡量获益和风险。

Clin Gastroenterol Hepatol:相比糖尿病前期患者,吡格列酮显著降低了2型糖尿病患者肝纤维化,并增加了脂肪组织胰岛素敏感性

在本项前瞻性研究中,发现吡格列酮对2型糖尿病患者有效。相比糖尿病前期患者,吡格列酮显著降低了2型糖尿病患者肝纤维化,并增加了脂肪组织胰岛素敏感性。

Lancet Diabetes Endo:吡格列酮的心血管风险如何?

2017年发表于《Lancet Diabetes Endocrinol》上的一项随机、多中心试验,考察了吡格列酮vs磺脲类药物对二甲双胍未充分控制血糖的2型糖尿病患者心血管事件发生率的影响。

Circulation:吡格列酮预防近期TIA或缺血性卒中患者卒中再发!

由此可见,吡格列酮在胰岛素抵抗的非糖尿病患者缺血性卒中二级预防中有效。

Cardiovasc Diabetol:吡格列酮对心血管疾病患者的不良结局有何影响?

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