他汀类药物和糖尿病:有什么联系?

IF 6.1 1区 医学 Q1 ENDOCRINOLOGY & METABOLISM
Naveed Sattar (Professor)
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引用次数: 6

摘要

随机试验表明,中等强度的他汀类药物会使2型糖尿病的风险增加约11%,而高强度他汀类药物可能会使风险增加12%或更多。这些数据转化为5年内每100-200名他汀类药物接受者中就有一例额外的糖尿病病例,对主要血管结果的益处增加约10倍。糖尿病危害的潜在机制尚不清楚,但可能包括适度的体重增加(在随机试验中注意到),或者推测是β细胞损伤。一致的遗传学研究将HMG-CoA还原酶抑制与糖尿病风险和体重增加联系起来。当给患者开他汀类药物时,应该警告他们有轻微的糖尿病风险,并告诉他们适度的生活方式改善可以i)消除糖尿病风险,ii)改善他汀类药物以外的心血管风险。医生还应测量他汀类药物使用后的血糖状况,最常见的是HbA1c,并根据结果制定生活方式建议和护理。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Statins and diabetes: What are the connections?

Randomized trials suggest moderate-intensity statins increase type 2 diabetes risk by around 11% with a potential further 12% moving to high-intensity statins, such that high intensity may increase risk by 20% or more relative to placebo. These data translate into one extra diabetes case per 100–200 statin recipients over 5 years, with ∼10-fold greater benefits on major vascular outcomes. The underlying mechanisms for diabetes harm are not clear but could include modest weight gain (noted in randomized trials), or, speculatively, beta cell harm. Concordant genetic studies link HMG CoA Reductase inhibition to diabetes risk and weight gain. Patients should be warned about a slight diabetes risk when prescribed statin and told that modest lifestyle improvements can i) nullify diabetes risk, and ii) improve cardiovascular risks beyond statins. Doctors should also measure glycemia status post statin commencement, most commonly with HbA1c, and tailor lifestyle advice and care dependent on the results.

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来源期刊
CiteScore
11.90
自引率
0.00%
发文量
77
审稿时长
6-12 weeks
期刊介绍: Best Practice & Research Clinical Endocrinology & Metabolism is a serial publication that integrates the latest original research findings into evidence-based review articles. These articles aim to address key clinical issues related to diagnosis, treatment, and patient management. Each issue adopts a problem-oriented approach, focusing on key questions and clearly outlining what is known while identifying areas for future research. Practical management strategies are described to facilitate application to individual patients. The series targets physicians in practice or training.
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