JCEM:二甲双胍治疗的2型糖尿病患者添加阿卡波糖与磺脲类药物的心血管益处比较

2018-08-04 xing.T MedSci原创

由此可见,在T2D患者的治疗中,与磺脲类药物相比,使用阿卡波糖作为二甲双胍的附加药物可降低主要动脉粥样硬化事件、缺血性卒中和低血糖的风险。

尽管α-葡萄糖苷酶抑制剂(AGI)已被证明可降低糖耐量异常(IGT)患者心肌梗死的风险,但AGI在2型糖尿病(T2D)中的血管益处尚未明确。近日,内分泌和代谢性疾病领域权威杂志Journal of Clinical Endocrinology & Metabolism上发表了一篇研究文章。研究人员旨在比较将阿卡波糖与磺脲类药物添加到二甲双胍治疗方案对T2D患者的临床效果。

研究人群来自台湾糖尿病绩效工资计划(P4P)数据库。磺酰脲类和阿卡波糖分别于2004-2015年间添加到196143例和14306例T2D患者处方中,同时都接受二甲双胍治疗。研究人员进行了倾向评分匹配的队列研究,随访了患者的全因死亡率和主要动脉粥样硬化事件(心肌梗塞和缺血性卒中)、心力衰竭或低血糖症的住院治疗的临床不良事件。

该研究共招募了14306个倾向评分匹配对子(55.8±13.1岁,47.8%为男性)。在考虑了主要的混杂因素后,研究人员发现与磺脲类药物作为二甲双胍的附加疗法相比,使用阿卡波糖可显著降低主要动脉粥样硬化事件(风险比和95%置信区间为0.69,0.52-0.91)、缺血性卒中(0.68,0.49-0.94)和低血糖(0.23,0.08-0.71)的住院风险。

由此可见,在T2D患者的治疗中,与磺脲类药物相比,使用阿卡波糖作为二甲双胍的附加药物可降低主要动脉粥样硬化事件、缺血性卒中和低血糖的风险。

原始出处:

Pai-Feng Hsu,et al. Cardiovascular benefits of acarbose versus sulfonylureas in type 2 diabetic patients treated with metformin.J Clin Endocrinol Metab. 2018. https://doi.org/10.1210/jc.2018-00040

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    2019-01-11 仁者大医
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    2019-06-09 achengzhao
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level=null, likeNumber=85, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2019/12/23/2f51002e1349ccda5be11c1eea1e1e60.jpg, createdBy=a22097948, createdName=天地飞扬, createdTime=Sat Aug 04 21:30:12 CST 2018, time=2018-08-04, status=1, ipAttribution=)]
    2018-08-05 天地飞扬

    了解一下,谢谢分享!

    0

  8. 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objectType=article, channel=null, level=null, likeNumber=81, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=misszhang, createdTime=Sun Aug 05 00:21:00 CST 2018, time=2018-08-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=336435, encodeId=ddd333643550, content=学习了,谢谢分享。, beContent=null, objectType=article, channel=null, level=null, likeNumber=86, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/xkvRjYnJzzRJ2R0y7VhicibvkjPWHjIMmu4ZpKnE9cWAu4lVicS3uDUCfF4M4JWvrkrYfpb2KehPV0Ee29tPqyPEebBUibiaKhnvD/0, createdBy=f8412001184, createdName=惠映实验室, createdTime=Sat Aug 04 22:29:22 CST 2018, time=2018-08-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=336423, encodeId=87ad3364238f, content=了解一下,谢谢分享!, beContent=null, objectType=article, channel=null, level=null, likeNumber=85, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2019/12/23/2f51002e1349ccda5be11c1eea1e1e60.jpg, createdBy=a22097948, createdName=天地飞扬, createdTime=Sat Aug 04 21:30:12 CST 2018, time=2018-08-04, status=1, ipAttribution=)]
    2018-08-05 misszhang

    谢谢MedSci提供最新的威廉亚洲官网

    0

  9. 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level=null, likeNumber=85, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2019/12/23/2f51002e1349ccda5be11c1eea1e1e60.jpg, createdBy=a22097948, createdName=天地飞扬, createdTime=Sat Aug 04 21:30:12 CST 2018, time=2018-08-04, status=1, ipAttribution=)]
    2018-08-04 惠映实验室

    学习了,谢谢分享。

    0

  10. 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level=null, likeNumber=85, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2019/12/23/2f51002e1349ccda5be11c1eea1e1e60.jpg, createdBy=a22097948, createdName=天地飞扬, createdTime=Sat Aug 04 21:30:12 CST 2018, time=2018-08-04, status=1, ipAttribution=)]
    2018-08-04 天地飞扬

    了解一下,谢谢分享!

    0

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发表在《JAMA Intern Med》的一项由美国和澳大利亚学者进行的研究,考察了2型糖尿病患者肾功能范围内使用二甲双胍与发生乳酸性酸中毒之间的相关性。

Nat Med:”神药“二甲双胍竟能逆转肺纤维化?

提到二甲双胍(metformin),人们最先想到的是它是治疗2型糖尿病的药物。确实,二甲双胍是治疗2型糖尿病的一线药物,通常2型糖尿病患者最先服用的药物就是它。但今日在《Nature Medicine》上发表的一项科学研究表明它还有让人意想不到的功用,美国阿拉巴马大学伯明翰分校(University of Alabama at Birmingham, UAB)的研究人员发现它可以逆转已经产生的肺纤