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JAMA Intern Med:肠促胰岛素类药物是否会增加急性胰腺炎风险?

2016-08-05 Mechront 译 MedSci原创

背景:基于肠促胰素的药物如二肽基肽酶4(DPP-4)抑制剂和胰高血糖素样肽1(GLP-1)受体激动剂,与急性胰腺炎之间的关联仍有争议。目的:肠促胰岛素类药物的使用与≥2种口服抗糖尿病药物相比,是否会增加急性胰腺炎风险。方法:大型的、国际的、多中心、以人群为基础的队列研究。纳入来自加拿大、美国和英国的 1532513例2型糖尿病患者,在2007-1-1至2013-6-30日使用降糖药物,随访至201

背景:基于肠促胰素的药物如二肽基肽酶4(DPP-4)抑制剂和胰高血糖素样肽1(GLP-1)受体激动剂,与急性胰腺炎之间的关联仍有争议。

目的:肠促胰岛素类药物的使用与≥2种口服抗糖尿病药物相比,是否会增加急性胰腺炎风险。

方法:大型的、国际的、多中心、以人群为基础的队列研究。纳入来自加拿大、美国和英国的 1532513例2型糖尿病患者,在2007-1-1至2013-6-30日使用降糖药物,随访至2014年6月30日。对急性胰腺炎住院患者进行嵌套的病例对照分析,匹配高达20名对照组(性别、年龄、队列进入日期、治疗糖尿病的持续时间、随访持续时间)。比较肠促胰岛素类药物的使用与≥2种口服抗糖尿病药物对急性胰腺炎风险的影响;进一步的分析评估不同类药物(DPP-4抑制剂和GLP-1激动剂)或使用时间对风险的影响。

结果:1532513例患者种男性为781567(51%)例,平均年龄为56.6岁。在3464659人年的随访中,发生了5165例住院治疗的急性胰腺炎(发病率,1.49/1000人年)。与当前使用≥2种口服降糖药相比,目前使用基于肠促胰素的药物与急性胰腺炎风险增加无关(aHR=1.03; 95% CI, 0.87-1.22)。不同药物分类对风险联系的影响不大(DPP-4抑制剂类药物:aHR=1.09; 95% CI, 0.86-1.22;GLP-1受体激动剂:aHR=1.04; 95% CI, 0.81-1.35);药物使用时间对风险联系的影响不大。

结论:此项大型人口为基础的研究表明,与其他口服抗糖尿病药物相比较,使用基于肠促胰素的药物不增加急性胰腺炎的风险。

原始出处:


Azoulay L, Filion KB.et al.Association Between Incretin-Based Drugs and the Risk of Acute Pancreatitis.JAMA Intern Med. 2016 Aug 1. doi: 10.1001/jamainternmed.2016.1522. [Epub ahead of print]

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  1. [GetPortalCommentsPageByObjectIdResponse(id=1749623, encodeId=68d11e49623ab, content=<a href='/topic/show?id=be7c8385345' target=_blank style='color:#2F92EE;'>#胰岛#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=83853, encryptionId=be7c8385345, topicName=胰岛)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a7a536274692, createdName=baoya, createdTime=Mon Apr 17 05:53:00 CST 2017, time=2017-04-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=139285, encodeId=3fac13928529, content=谢谢谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=84, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib06iaV3D9Tg5K46ZAxBHmHsph32KkfsWGwmickB6RsCUD8KruE4vo5CpvXfdu16GBpp4ibh6WJu1o9iatP1LWKDmvmic/0, createdBy=be6f1940165, createdName=1e0ece0dm09(暂无匿称), createdTime=Mon Oct 03 00:32:26 CST 2016, time=2016-10-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=131745, encodeId=117b131e45b6, content=文章很好,非常有益, beContent=null, objectType=article, channel=null, level=null, likeNumber=95, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzdAIB7UwTkHt6fQkBP8ictliaXtc5gCUmYdAW1sAETC2nhO3q6YjRHkUibyOCtP8ibmXNObTyd63A076/0, createdBy=d4111948983, createdName=1e10c84am36(暂无匿称), createdTime=Tue Sep 20 22:25:00 CST 2016, time=2016-09-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=125489, encodeId=107b12548945, content=这是一个好消息,但是会增加胆囊疾病的风险吗, beContent=null, objectType=article, channel=null, level=null, likeNumber=87, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160907/IMG57D00CF1965701770.jpg, createdBy=565c1948251, createdName=舒心和人, createdTime=Tue Sep 13 16:17:00 CST 2016, time=2016-09-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1551618, encodeId=9fd4155161890, content=<a href='/topic/show?id=2c838152309' target=_blank style='color:#2F92EE;'>#肠促胰岛素#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=78, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=81523, encryptionId=2c838152309, topicName=肠促胰岛素)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=e5d514195798, createdName=Boyinsh, createdTime=Sun Aug 07 00:53:00 CST 2016, time=2016-08-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1607011, encodeId=3fd8160e011a7, content=<a href='/topic/show?id=eb6b1145939' target=_blank style='color:#2F92EE;'>#Med#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11459, encryptionId=eb6b1145939, topicName=Med)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=552a19396740, createdName=ms3994565386320060, createdTime=Sun Aug 07 00:53:00 CST 2016, time=2016-08-07, status=1, ipAttribution=)]
    2017-04-17 baoya
  2. [GetPortalCommentsPageByObjectIdResponse(id=1749623, encodeId=68d11e49623ab, content=<a href='/topic/show?id=be7c8385345' target=_blank style='color:#2F92EE;'>#胰岛#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=83853, encryptionId=be7c8385345, topicName=胰岛)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a7a536274692, createdName=baoya, createdTime=Mon Apr 17 05:53:00 CST 2017, time=2017-04-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=139285, encodeId=3fac13928529, content=谢谢谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=84, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib06iaV3D9Tg5K46ZAxBHmHsph32KkfsWGwmickB6RsCUD8KruE4vo5CpvXfdu16GBpp4ibh6WJu1o9iatP1LWKDmvmic/0, createdBy=be6f1940165, createdName=1e0ece0dm09(暂无匿称), createdTime=Mon Oct 03 00:32:26 CST 2016, time=2016-10-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=131745, encodeId=117b131e45b6, content=文章很好,非常有益, beContent=null, objectType=article, channel=null, level=null, likeNumber=95, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzdAIB7UwTkHt6fQkBP8ictliaXtc5gCUmYdAW1sAETC2nhO3q6YjRHkUibyOCtP8ibmXNObTyd63A076/0, createdBy=d4111948983, createdName=1e10c84am36(暂无匿称), createdTime=Tue Sep 20 22:25:00 CST 2016, time=2016-09-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=125489, encodeId=107b12548945, content=这是一个好消息,但是会增加胆囊疾病的风险吗, beContent=null, objectType=article, channel=null, level=null, likeNumber=87, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160907/IMG57D00CF1965701770.jpg, createdBy=565c1948251, createdName=舒心和人, createdTime=Tue Sep 13 16:17:00 CST 2016, time=2016-09-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1551618, encodeId=9fd4155161890, content=<a href='/topic/show?id=2c838152309' target=_blank style='color:#2F92EE;'>#肠促胰岛素#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=78, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=81523, encryptionId=2c838152309, topicName=肠促胰岛素)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=e5d514195798, createdName=Boyinsh, createdTime=Sun Aug 07 00:53:00 CST 2016, time=2016-08-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1607011, encodeId=3fd8160e011a7, content=<a href='/topic/show?id=eb6b1145939' target=_blank style='color:#2F92EE;'>#Med#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11459, encryptionId=eb6b1145939, topicName=Med)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=552a19396740, createdName=ms3994565386320060, createdTime=Sun Aug 07 00:53:00 CST 2016, time=2016-08-07, status=1, ipAttribution=)]
    2016-10-03 1e0ece0dm09(暂无匿称)

    谢谢谢谢分享

    0

  3. [GetPortalCommentsPageByObjectIdResponse(id=1749623, encodeId=68d11e49623ab, content=<a href='/topic/show?id=be7c8385345' target=_blank style='color:#2F92EE;'>#胰岛#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=83853, encryptionId=be7c8385345, topicName=胰岛)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a7a536274692, createdName=baoya, createdTime=Mon Apr 17 05:53:00 CST 2017, time=2017-04-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=139285, encodeId=3fac13928529, content=谢谢谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=84, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib06iaV3D9Tg5K46ZAxBHmHsph32KkfsWGwmickB6RsCUD8KruE4vo5CpvXfdu16GBpp4ibh6WJu1o9iatP1LWKDmvmic/0, createdBy=be6f1940165, createdName=1e0ece0dm09(暂无匿称), createdTime=Mon Oct 03 00:32:26 CST 2016, time=2016-10-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=131745, encodeId=117b131e45b6, content=文章很好,非常有益, beContent=null, objectType=article, channel=null, level=null, likeNumber=95, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzdAIB7UwTkHt6fQkBP8ictliaXtc5gCUmYdAW1sAETC2nhO3q6YjRHkUibyOCtP8ibmXNObTyd63A076/0, createdBy=d4111948983, createdName=1e10c84am36(暂无匿称), createdTime=Tue Sep 20 22:25:00 CST 2016, time=2016-09-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=125489, encodeId=107b12548945, content=这是一个好消息,但是会增加胆囊疾病的风险吗, beContent=null, objectType=article, channel=null, level=null, likeNumber=87, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160907/IMG57D00CF1965701770.jpg, createdBy=565c1948251, createdName=舒心和人, createdTime=Tue Sep 13 16:17:00 CST 2016, time=2016-09-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1551618, encodeId=9fd4155161890, content=<a href='/topic/show?id=2c838152309' target=_blank style='color:#2F92EE;'>#肠促胰岛素#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=78, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=81523, encryptionId=2c838152309, topicName=肠促胰岛素)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=e5d514195798, createdName=Boyinsh, createdTime=Sun Aug 07 00:53:00 CST 2016, time=2016-08-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1607011, encodeId=3fd8160e011a7, content=<a href='/topic/show?id=eb6b1145939' target=_blank style='color:#2F92EE;'>#Med#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11459, encryptionId=eb6b1145939, topicName=Med)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=552a19396740, createdName=ms3994565386320060, createdTime=Sun Aug 07 00:53:00 CST 2016, time=2016-08-07, status=1, ipAttribution=)]
    2016-09-20 1e10c84am36(暂无匿称)

    文章很好,非常有益

    0

  4. [GetPortalCommentsPageByObjectIdResponse(id=1749623, encodeId=68d11e49623ab, content=<a href='/topic/show?id=be7c8385345' target=_blank style='color:#2F92EE;'>#胰岛#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=83853, encryptionId=be7c8385345, topicName=胰岛)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a7a536274692, createdName=baoya, createdTime=Mon Apr 17 05:53:00 CST 2017, time=2017-04-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=139285, encodeId=3fac13928529, content=谢谢谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=84, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib06iaV3D9Tg5K46ZAxBHmHsph32KkfsWGwmickB6RsCUD8KruE4vo5CpvXfdu16GBpp4ibh6WJu1o9iatP1LWKDmvmic/0, createdBy=be6f1940165, createdName=1e0ece0dm09(暂无匿称), createdTime=Mon Oct 03 00:32:26 CST 2016, time=2016-10-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=131745, encodeId=117b131e45b6, content=文章很好,非常有益, beContent=null, objectType=article, channel=null, level=null, likeNumber=95, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzdAIB7UwTkHt6fQkBP8ictliaXtc5gCUmYdAW1sAETC2nhO3q6YjRHkUibyOCtP8ibmXNObTyd63A076/0, createdBy=d4111948983, createdName=1e10c84am36(暂无匿称), createdTime=Tue Sep 20 22:25:00 CST 2016, time=2016-09-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=125489, encodeId=107b12548945, content=这是一个好消息,但是会增加胆囊疾病的风险吗, beContent=null, objectType=article, channel=null, level=null, likeNumber=87, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160907/IMG57D00CF1965701770.jpg, createdBy=565c1948251, createdName=舒心和人, createdTime=Tue Sep 13 16:17:00 CST 2016, time=2016-09-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1551618, encodeId=9fd4155161890, content=<a href='/topic/show?id=2c838152309' target=_blank style='color:#2F92EE;'>#肠促胰岛素#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=78, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=81523, encryptionId=2c838152309, topicName=肠促胰岛素)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=e5d514195798, createdName=Boyinsh, createdTime=Sun Aug 07 00:53:00 CST 2016, time=2016-08-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1607011, encodeId=3fd8160e011a7, content=<a href='/topic/show?id=eb6b1145939' target=_blank style='color:#2F92EE;'>#Med#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11459, encryptionId=eb6b1145939, topicName=Med)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=552a19396740, createdName=ms3994565386320060, createdTime=Sun Aug 07 00:53:00 CST 2016, time=2016-08-07, status=1, ipAttribution=)]
    2016-09-13 舒心和人

    这是一个好消息,但是会增加胆囊疾病的风险吗

    0

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