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BMJ：DPP-4抑制剂以及GLP-1激动剂或导致糖尿病患者胆管癌风险增加

2018-12-11 zhangfan MedSci原创

糖尿病胆管癌DPP-4GLP-1
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研究认为，相比于传统二三线抗糖尿病药物，新型DPP-4抑制剂以及GLP-1激动剂导致患者胆管癌风险增加

近日研究人员考察了II型糖尿病患者服用二肽基肽酶-4(DPP-4)抑制剂和胰高血糖素样肽-1(GLP-1)受体激动剂与成年胆管癌风险的关系。

154162名新确诊患者参与研究，比较服用DPP-4抑制剂和GLP-1受体激动剂患者与其他二、三线抗糖尿病药物患者的胆管癌风险差异。

总计随访614274患者年，发生105起胆管癌，每100000患者年发生17.1例。研究发现，服用DPP-4抑制剂导致患者胆管癌风险增加77%，使用GLP-1激动剂同样增加风险，但置信区间较为宽泛（HR=1.97，95% CI=0.83-4.66）。药物警戒分析显示，与磺酰脲或噻唑烷二酮相比，DPP-4抑制剂以及GLP-1激动剂均导致胆管癌风险增加（1.63；4.73）。

研究认为，相比于传统二三线抗糖尿病药物，新型DPP-4抑制剂以及GLP-1激动剂导致患者胆管癌风险增加。

原始出处：

Devin Abrahami et al. Incretin based drugs and risk of cholangiocarcinoma among patients with type 2 diabetes： population based cohort study. BMJ. 05 December 2018.

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    2019-01-12 sjq027

    #癌风险#

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    2019-11-23 gaoxiaoe

    #BMJ#

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    2019-01-30 xue8602

    #DPP-4抑制#

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createdAvatar=https://wx.qlogo.cn/mmopen/vi_32/iaAVWEsIJUkA1ITy3uL0lhHUhyaJibWgFtH4KbJuaLbY2WUK33jgCFyoZ8Eqx7eE7hCuZhytc1C5GRrfjVXN8lYg/0, createdBy=fcb82149579, createdName=183****7028, createdTime=Sat Jan 19 12:17:53 CST 2019, time=2019-01-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=356649, encodeId=9728356649b7, content=学习了谢谢分享学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=81, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160304/IMG56D94856B1B5D6405.jpg, createdBy=27931687771, createdName=一个字-牛, createdTime=Sat Dec 29 06:47:54 CST 2018, time=2018-12-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1851863, encodeId=056f18518634d, content=<a href='/topic/show?id=f0a254918f0' target=_blank style='color:#2F92EE;'>#抑制剂#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=54918, encryptionId=f0a254918f0, topicName=抑制剂)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=44a360, createdName=jklm09, createdTime=Mon Dec 24 12:46:00 CST 2018, time=2018-12-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=355892, encodeId=9c793558925f, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=69, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/vi_32/iaAVWEsIJUkA1ITy3uL0lhHUhyaJibWgFtH4KbJuaLbY2WUK33jgCFyoZ8Eqx7eE7hCuZhytc1C5GRrfjVXN8lYg/0, createdBy=fcb82149579, createdName=183****7028, createdTime=Thu Dec 20 06:33:47 CST 2018, time=2018-12-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1401954, encodeId=d3591401954a3, content=<a href='/topic/show?id=7ff0621125' target=_blank style='color:#2F92EE;'>#DPP-4#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=6211, encryptionId=7ff0621125, topicName=DPP-4)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=55683, createdName=仁医06, createdTime=Thu Dec 13 01:46:00 CST 2018, time=2018-12-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1628359, encodeId=078c16283599a, content=<a href='/topic/show?id=9a4e83503e4' target=_blank style='color:#2F92EE;'>#胆管#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=83503, encryptionId=9a4e83503e4, topicName=胆管)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=c21721182790, createdName=cmj15wellington, createdTime=Thu Dec 13 01:46:00 CST 2018, time=2018-12-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1627776, encodeId=b7c0162e77613, content=<a href='/topic/show?id=ab4f66e8913' target=_blank style='color:#2F92EE;'>#激动剂#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=66789, encryptionId=ab4f66e8913, topicName=激动剂)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=95bc21134754, createdName=medscijoin, createdTime=Thu Dec 13 01:46:00 CST 2018, time=2018-12-13, status=1, ipAttribution=)]
    2019-01-19 183****7028

    学习

    0

  5. 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GetPortalCommentsPageByObjectIdResponse(id=1627776, encodeId=b7c0162e77613, content=<a href='/topic/show?id=ab4f66e8913' target=_blank style='color:#2F92EE;'>#激动剂#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=66789, encryptionId=ab4f66e8913, topicName=激动剂)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=95bc21134754, createdName=medscijoin, createdTime=Thu Dec 13 01:46:00 CST 2018, time=2018-12-13, status=1, ipAttribution=)]
    2018-12-29 一个字-牛

    学习了谢谢分享学习

    0

  6. 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style='color:#2F92EE;'>#DPP-4#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=6211, encryptionId=7ff0621125, topicName=DPP-4)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=55683, createdName=仁医06, createdTime=Thu Dec 13 01:46:00 CST 2018, time=2018-12-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1628359, encodeId=078c16283599a, content=<a href='/topic/show?id=9a4e83503e4' target=_blank style='color:#2F92EE;'>#胆管#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=83503, encryptionId=9a4e83503e4, topicName=胆管)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=c21721182790, createdName=cmj15wellington, createdTime=Thu Dec 13 01:46:00 CST 2018, time=2018-12-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1627776, encodeId=b7c0162e77613, content=<a href='/topic/show?id=ab4f66e8913' target=_blank style='color:#2F92EE;'>#激动剂#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=66789, encryptionId=ab4f66e8913, topicName=激动剂)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=95bc21134754, createdName=medscijoin, createdTime=Thu Dec 13 01:46:00 CST 2018, time=2018-12-13, status=1, ipAttribution=)]
    2018-12-24 jklm09

    #抑制剂#

    0

  7. 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style='color:#2F92EE;'>#DPP-4#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=6211, encryptionId=7ff0621125, topicName=DPP-4)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=55683, createdName=仁医06, createdTime=Thu Dec 13 01:46:00 CST 2018, time=2018-12-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1628359, encodeId=078c16283599a, content=<a href='/topic/show?id=9a4e83503e4' target=_blank style='color:#2F92EE;'>#胆管#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=83503, encryptionId=9a4e83503e4, topicName=胆管)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=c21721182790, createdName=cmj15wellington, createdTime=Thu Dec 13 01:46:00 CST 2018, time=2018-12-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1627776, encodeId=b7c0162e77613, content=<a href='/topic/show?id=ab4f66e8913' target=_blank style='color:#2F92EE;'>#激动剂#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=66789, encryptionId=ab4f66e8913, topicName=激动剂)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=95bc21134754, createdName=medscijoin, createdTime=Thu Dec 13 01:46:00 CST 2018, time=2018-12-13, status=1, ipAttribution=)]
    2018-12-20 183****7028

    学习

    0

  8. 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style='color:#2F92EE;'>#DPP-4#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=6211, encryptionId=7ff0621125, topicName=DPP-4)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=55683, createdName=仁医06, createdTime=Thu Dec 13 01:46:00 CST 2018, time=2018-12-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1628359, encodeId=078c16283599a, content=<a href='/topic/show?id=9a4e83503e4' target=_blank style='color:#2F92EE;'>#胆管#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=83503, encryptionId=9a4e83503e4, topicName=胆管)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=c21721182790, createdName=cmj15wellington, createdTime=Thu Dec 13 01:46:00 CST 2018, time=2018-12-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1627776, encodeId=b7c0162e77613, content=<a href='/topic/show?id=ab4f66e8913' target=_blank style='color:#2F92EE;'>#激动剂#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=66789, encryptionId=ab4f66e8913, topicName=激动剂)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=95bc21134754, createdName=medscijoin, createdTime=Thu Dec 13 01:46:00 CST 2018, time=2018-12-13, status=1, ipAttribution=)]
    2018-12-13 仁医06

    #DPP-4#

    0

  9. 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style='color:#2F92EE;'>#DPP-4#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=6211, encryptionId=7ff0621125, topicName=DPP-4)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=55683, createdName=仁医06, createdTime=Thu Dec 13 01:46:00 CST 2018, time=2018-12-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1628359, encodeId=078c16283599a, content=<a href='/topic/show?id=9a4e83503e4' target=_blank style='color:#2F92EE;'>#胆管#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=83503, encryptionId=9a4e83503e4, topicName=胆管)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=c21721182790, createdName=cmj15wellington, createdTime=Thu Dec 13 01:46:00 CST 2018, time=2018-12-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1627776, encodeId=b7c0162e77613, content=<a href='/topic/show?id=ab4f66e8913' target=_blank style='color:#2F92EE;'>#激动剂#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=66789, encryptionId=ab4f66e8913, topicName=激动剂)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=95bc21134754, createdName=medscijoin, createdTime=Thu Dec 13 01:46:00 CST 2018, time=2018-12-13, status=1, ipAttribution=)]
    2018-12-13 cmj15wellington

    #胆管#

    0

  10. 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GetPortalCommentsPageByObjectIdResponse(id=1627776, encodeId=b7c0162e77613, content=<a href='/topic/show?id=ab4f66e8913' target=_blank style='color:#2F92EE;'>#激动剂#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=66789, encryptionId=ab4f66e8913, topicName=激动剂)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=95bc21134754, createdName=medscijoin, createdTime=Thu Dec 13 01:46:00 CST 2018, time=2018-12-13, status=1, ipAttribution=)]
    2018-12-13 medscijoin

    #激动剂#

    0

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利拉鲁肽的使用还与患者心血管疾病死亡风险降低以及任何原因导致的死亡风险降低直接相关，在亚群分析中，研究者指出，有心血管疾病史的患者似乎会因利拉鲁肽疗法而获益，尽管其与无疾病史患者之间并无统计学意义。最后研究者Bjorn Pasternak说道，本文研究表明，药物利拉鲁肽在更广泛的未选择的患者群体中能带来心血管健康的益处，同时还能提供重要的临床验证证据。

Nature Metabolism：科学家开发出一种治疗2型糖尿病的新疗法

恢复胰岛素的功能是治疗2型糖尿病的一个关键，近日，一项刊登在国际杂志Nature Metabolism上的研究报告中，来自图卢兹大学的科学家们通过研究开发了一种新型治疗策略，其能利用一种名为激素敏感性脂肪酶（hormone-sensitive lipase， HSL）的特殊酶类来发挥作用，当在脂肪细胞中刺激脂肪合成时，或许就会对胰岛素的活性带来有益效应。

Diabetes Care：BMI高合并子痫前期，增加产后T2DM风险

一项最新研究结果表明，体质指数（BMI）高且有妊娠期高血压疾病（HDP，如子痫前期和妊娠期高血压）的女性在产后患2型糖尿病（T2DM）的风险增加。

Mol Metab：单次运动就能带来长效的代谢益处？

一项新的小鼠研究表明，单次运动就能激活与食欲降低、血糖水平下降和代谢改善相关的大脑回路。而且在运动过后，这种效应能持续两天。该发现有助于改善糖尿病患者的血糖代谢。

超500亿的糖尿病用药市场生变，跨国药企的危机来了！

日前，华东医药发布《公告》称，其全资子公司中美华东收到国家药品监督管理局批准签发的《药品补充申请批件》。中美华东生产的阿卡波糖片（50mg）国内首家通过仿制药质量和疗效一致性评价。

JACC：SYNTAX 评分在糖尿病伴复杂冠心病患者中的应用

糖尿病（DM）与复杂型冠心病的发生相关，从而增加了心血管并发症的发病率和死亡率。本研究的目的旨在通过SYNTAX 评分（SS）预测接受冠脉搭桥（CABG）或经皮冠脉介入治疗（PCI）的糖尿病伴复杂冠心病患者的心血管预后。本研究纳入分析了FREEDOM 临床试验中的患者，硬性心血管终点事件（HCE）为全因死亡、非致死性心梗和非致死性卒中的复合事件，主要不良心脑血管事件（MACCE）为HCE和反复性血