2 型糖尿病和无症状高尿酸血症患者开始接受降尿酸治疗与全因死亡率之间的关系

IF 4.3 Q1 ENDOCRINOLOGY & METABOLISM
Ruixuan Chen , Sheng Nie , Shiyu Zhou , Licong Su , Yanqin Li , Xiaodong Zhang , Fan Luo , Ruqi Xu , Qi Gao , Yuxin Lin , Zhixin Guo , Lisha Cao , Xin Xu
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引用次数: 0

摘要

目的评估无症状高尿酸血症和 2 型糖尿病(T2D)患者开始接受降尿酸治疗(ULT)与全因死亡率之间的关系。方法这项全国性回顾性队列研究涉及 2000 年至 2021 年期间中国 19 家学术医院的 T2D 和无症状高尿酸血症患者。主要暴露是开始使用超低浓度治疗,包括别嘌醇、非布司他或苯溴马隆。主要结果为全因死亡率。次要结果为心血管 (CV) 和非 CV 死亡率。该研究采用倾向评分匹配法建立了1:2的匹配队列,且开始使用超短波治疗的可能性均衡。结果在 42 507 名患者中,5028 人开始使用 ULT,37 479 人未使用。在由 4871 名 ULT 启动者和 9047 名非启动者组成的匹配队列中,在平均 3.0 年的随访期间,ULT 启动与全因死亡风险降低(危险比 [HR] 0.77;95% 置信区间 [CI],0.71-0.84)、CV 死亡率(HR 0.86;95% CI,0.76-0.97)和非 CV 死亡率(HR 0.72;95% CI,0.64-0.80)显著相关。在ULT启动者中,与>420 μmol/L水平相比,治疗后SUA水平为360-420 μmol/L与全因死亡风险显著降低有关(HR为0.74;95% CI为0.59-0.94),而≤360 μmol/L水平与全因死亡风险无关(HR为0.结论在患有 T2D 和无症状高尿酸血症的患者中,启动 ULT 可显著降低全因死亡率。值得注意的是,将治疗后的 SUA 浓度维持在 360-420 μmol/L 的范围内可能会提高死亡率的降低幅度。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Association between urate-lowering therapy initiation and all-cause mortality in patients with type 2 diabetes and asymptomatic hyperuricemia

Aims

To assess the relationships between urate-lowering therapy (ULT) initiation with all-cause mortality in patients with asymptomatic hyperuricemia and Type 2 Diabetes (T2D).

Methods

This nationwide retrospective cohort study involved patients with T2D and asymptomatic hyperuricemia from 19 academic hospitals across China between 2000 and 2021. The primary exposure was ULT initiation, including allopurinol, febuxostat, or benzbromarone. The primary outcome was all-cause mortality. The secondary outcomes were cardiovascular (CV) and non-CV mortality. Propensity score matching was employed to create a 1:2 matched cohort with balanced likelihood of ULT initiation. Associations between ULT initiation with all-cause and CV mortality were assessed in the matched cohort.

Results

Among 42 507 patients, 5028 initiated ULT and 37 479 did not. In the matched cohort, comprising 4871 ULT initiators and 9047 noninitiators, ULT initiation was significantly associated with reduced risk of all-cause mortality (hazard ratio [HR] 0.77; 95% confidence interval [CI], 0.71–0.84), CV mortality (HR 0.86; 95% CI, 0.76–0.97), and non-CV mortality (HR 0.72; 95% CI, 0.64–0.80) over an average 3.0 years of follow-up. Among the ULT initiators, post-treatment SUA levels of 360–420 μmol/L was related to a significantly lower risk for all-cause mortality compared to levels >420 μmol/L (HR 0.74; 95% CI, 0.59–0.94) while levels ≤360 μmol/L did not (HR, 0.96; 95% CI, 0.81–1.14), suggesting a U-shaped relationship.

Conclusions

Initiating ULT was associated with a significant reduction in all-cause mortality in patients with T2D and asymptomatic hyperuricemia. Notably, maintaining post-treatment SUA concentrations within 360–420 μmol/L could potentially enhance this reduced mortality.

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来源期刊
CiteScore
22.90
自引率
2.00%
发文量
248
审稿时长
51 days
期刊介绍: Diabetes and Metabolic Syndrome: Clinical Research and Reviews is the official journal of DiabetesIndia. It aims to provide a global platform for healthcare professionals, diabetes educators, and other stakeholders to submit their research on diabetes care. Types of Publications: Diabetes and Metabolic Syndrome: Clinical Research and Reviews publishes peer-reviewed original articles, reviews, short communications, case reports, letters to the Editor, and expert comments. Reviews and mini-reviews are particularly welcomed for areas within endocrinology undergoing rapid changes.
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