钠-葡萄糖共转运蛋白2抑制剂与2型糖尿病患者COVID-19结局：一项基于人群的队列研究

IF 1 Q4 ENDOCRINOLOGY & METABOLISM

Diabetes epidemiology and management Pub Date : 2025-07-01 DOI:10.1016/j.deman.2025.100273

Cerina Dubois , Jasjeet K Minhas-Sandhu , Wajd Alkabbani , Jason R.B. Dyck , Dean T. Eurich

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引用次数: 0

摘要

钠-葡萄糖共转运蛋白2 （SGLT2）抑制剂（SGLT-2i）被认为对2019冠状病毒病（COVID-19）的治疗有益；然而，动物和临床数据并不一致。本研究的目的是评估与2型糖尿病患者使用SGLT-2i相关的SARS-CoV-2感染风险和与covid -19相关的不良预后。方法：这是一项基于比较人群的回顾性队列研究，研究对象是2012年1月1日至2021年3月31日在加拿大阿尔伯塔省新使用SGLT-2i或二肽基肽酶-4 （DPP-4）抑制剂（DPP-4i）的患者。我们评估了：1)COVID-19检测阳性（或SARS-CoV-2血清阳性）；2)围绕COVID-19检测阳性的全因事件（住院、急诊、死亡）；3)与COVID-19检测阳性相关的COVID-19特定事件（住院、急诊、死亡）。在1:1高维倾向评分（hdPS）匹配后，我们使用条件Cox比例风险回归估计了风险比（HR）和95%置信区间（CI）。结果SGLT-2i用户37,079人，DPP-4i用户39,053人（配对对30,433对）。调整后，与DPP-4i相比，SGLT-2i的使用与COVID-19检测阳性的相关性最小[HR: 1.23；95% ci: 1.02-1.49]。二级队列比较者的covid -19阳性检测风险结果具有统计学意义。SGLT-2i也与covid -19特异性事件的高风险相关[HR: 1.66；95% CI: 1.12-2.45]与DPP-4i相比。结论与DPP-4i相比，sglt -2i可能与成人2型糖尿病患者中所有压实器中COVID-19阳性试验和COVID-19特异性事件的适度增加有关。然而，这一发现的临床影响尚不确定。需要进一步的前瞻性研究来评估2型糖尿病患者使用SGLT-2i与covid -19相关结局之间的关系。

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Sodium-glucose cotransporter 2 Inhibitors and COVID-19 outcomes in type 2 diabetes patients: A population-based cohort study

Introduction

Sodium-glucose cotransporter 2 (SGLT2) inhibitors (SGLT-2i) have been suggested to be beneficial in the management of Coronavirus disease 2019 (COVID-19); however, animal and clinical data have been inconsistent. The objective of this study was to assess the risk of SARS-CoV-2 infection and poor COVID-19-related outcomes associated with SGLT-2i use in patients with type 2 diabetes.

Methods

This is a comparative population-based retrospective cohort study on new users of SGLT-2i or dipeptidyl peptidase-4 (DPP-4) inhibitors (DPP-4i) from January 1, 2012 to March 31, 2021 in Alberta, Canada. We assessed: 1) presence of a positive COVID-19 test (or seropositivity for SARS-CoV-2); 2) an all-cause event around positive COVID-19 test (hospital admission, emergency department visit, death); and 3) a COVID-19-specific-event(hospital admission, emergency department visit, death) around positive COVID-19 test. We estimated the hazard ratio (HR) and 95% Confidence interval (CI) using a conditional Cox proportional hazard regression after 1:1 high-dimensional propensity score (hdPS) matching.

Results

There were 37,079 SGLT-2i and 39,053 DPP-4i users (30,433 matched pairs). After adjustment, compared to DPP-4i, SGLT-2i use was minimally associated with a positive COVID-19 test [HR: 1.23; 95% CI: 1.02–1.49]. Results were statistically significant across secondary cohort comparators for the risk of a COVID-19-positive test. SGLT-2i was also associated with a higher risk in a COVID-19-specific event [HR: 1.66; 95% CI: 1.12–2.45] compared to DPP-4i.

Conclusion

SGLT-2i may be associated with a modest increase in positive COVID-19 tests across all compactors and COVID-19-specific events compared to DPP-4i among adults with type 2 diabetes. However, the clinical impact of this finding is uncertain. There is a need for further prospective studies to assess the relationship between SGLT-2i use and COVID-19-related outcomes in patients with type 2 diabetes.

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来源期刊

Diabetes epidemiology and management Endocrinology, Diabetes and Metabolism, Public Health and Health Policy

CiteScore

1.10

自引率

0.00%

发文量

审稿时长

14 days