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J Diabetes:警惕!糖皮质激素显著增加2型糖尿病患者的致命并发症

2017-12-25 佚名 来宝网

在一项新的研究中,研究人员表示,服用短期口服糖皮质激素的成人2型糖尿病患者发生不良事件的风险增加。

在一项新的研究中,研究人员表示,服用短期口服糖皮质激素的成人2型糖尿病患者发生不良事件的风险增加。

来自密歇根大学的研究人员在报告中指出,长期服用糖皮质激素的风险因素以及副作用是众所周知的,根据糖尿病管理指南,在开始使用口服皮质类固醇时对血糖进行仔细监测的建议,并且进行胰岛素给药校正,以避免高血糖症的发生。“短期使用糖皮质激素”通常被认为是安全的,但最近的研究发现,短期使用也会增加风险,虽然频率并不高。

由于不良事件很少发生,因此在随机对照试验的范围内,统计力较低。研究人员对1,548,945名18至64岁的患者进行了纵向研究,数据资料来自大型国家健康保险公司,自2012年至2014年期间收集数据。研究人员使用Poisson回归计算不良事件的发生率比率。在报告中,研究人员指出,近四分之一的2型糖尿病患者使用短期糖皮质激素(23.9%),1型糖尿病患者的使用比例为20.8%,无糖尿病的其他人群使用的比例为20.9%。

患有糖尿病的患者有更大的败血症、骨折和静脉血栓栓塞的基线风险。研究人员称,使用糖皮质激素并同时患有糖尿病会大大增加风险比例。

研究人员指出:“在随机试验中,特别是在使用皮质类固醇的糖尿病患者中,应研究添加麦角钙化醇以预防骨折,增加他汀类药物以防止脓毒症的发生。”

原始出处:
Rogers MAM, Lin P, Nallamothu BK, et al.Longitudinal Study of Short-term Corticosteroid Use by Working-Age Adults with Diabetes Mellitus: Risks and Mitigating Factors.J Diabetes. 2017 Nov 28. doi: 10.1111/1753-0407.12631. [Epub ahead of print]

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content=学习了谢谢作者分享!, beContent=null, objectType=article, channel=null, level=null, likeNumber=81, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3xJXLtMtt5B40XXuPjn9xn1rBhrM6fHLkX1hI86ZoWoPJkgDkZuJNKkBfBHOcRd1fAdezg7JlHNOokohdAp3WkI/0, createdBy=32c81964262, createdName=1e145228m78(暂无匿称), createdTime=Tue Jan 16 00:03:04 CST 2018, time=2018-01-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1383382, encodeId=5c2c13833828b, content=<a href='/topic/show?id=196a1101f7' target=_blank style='color:#2F92EE;'>#2型糖尿病患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=75, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=1101, encryptionId=196a1101f7, topicName=2型糖尿病患者)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ec19483, createdName=aids213, createdTime=Wed Dec 27 06:24:00 CST 2017, time=2017-12-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1474380, encodeId=8d8c14e438098, content=<a href='/topic/show?id=935fe6718e3' target=_blank style='color:#2F92EE;'>#糖尿病患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=62, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=76718, encryptionId=935fe6718e3, topicName=糖尿病患者)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a38f7243741, createdName=xue8604, createdTime=Wed Dec 27 06:24:00 CST 2017, time=2017-12-27, status=1, ipAttribution=)]
    2018-08-26 丁鹏鹏
  5. 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time=2017-12-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1474380, encodeId=8d8c14e438098, content=<a href='/topic/show?id=935fe6718e3' target=_blank style='color:#2F92EE;'>#糖尿病患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=62, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=76718, encryptionId=935fe6718e3, topicName=糖尿病患者)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a38f7243741, createdName=xue8604, createdTime=Wed Dec 27 06:24:00 CST 2017, time=2017-12-27, status=1, ipAttribution=)]
    2018-03-20 135****7952平儿

    学了......

    0

  6. 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time=2017-12-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1474380, encodeId=8d8c14e438098, content=<a href='/topic/show?id=935fe6718e3' target=_blank style='color:#2F92EE;'>#糖尿病患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=62, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=76718, encryptionId=935fe6718e3, topicName=糖尿病患者)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a38f7243741, createdName=xue8604, createdTime=Wed Dec 27 06:24:00 CST 2017, time=2017-12-27, status=1, ipAttribution=)]
    2018-02-22 135****7952平儿

    学了.........

    0

  7. 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    2018-01-16 1e145228m78(暂无匿称)

    学习了谢谢作者分享!

    0

  9. 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2017年9月,发表在《BMJ》上的一项系统回顾和Meta分析,研究了糖皮质激素作为辅助疗法治疗喉咙痛的获益和危害。分析结果表明:单次低剂量糖皮质激素可缓解喉咙痛患者的疼痛,而不会增加严重不良反应。

Blood:LCK抑制剂可逆转儿童T-ALL对糖皮质激素的耐药性。

急性T淋巴细胞白血病(T-ALL)患儿常对糖皮质激素(GC)治疗产生耐药性。对于这些患者,被归类为强的松低反应者(PPR),与其他接受高风险的适应性疗法的T-ALL患儿相比,预后较差。

Exp Ther Med:糖皮质激素的鼻内使用可缓解过敏性鼻炎中的嗅觉障碍

最近,有研究人员调查了糖皮质激素的干预对患有过敏性鼻炎(AR)小鼠嗅觉障碍的影响。研究人员通过对小鼠进行腹腔内注射和鼻内使用卵清建立了一个AR动物模型,并利用埋藏食物测试来评估嗅觉功能,并且利用苏木精和伊红染色来确定鼻粘膜上的形态变化。另外,研究人员还通过免疫组化技术检测了嗅觉黏膜上的嗅觉标记蛋白(OMP)的表达情况,并且在糖皮质激素使用7天和14天后进行了观察。研究发现,AR小鼠中嗅觉障碍的发生

Ann Rheum Dis:糖皮质激素在早期类风湿关节炎患者中的耐受性如何?

2017年11月,发表于《Ann Rheum Dis》的ESPOIR试验数据,考察了糖皮质激素(GC)在早期类风湿关节炎(RA)患者中使用的7年耐受性特征。

J Rheumatol:系统性红斑狼疮患者糖皮质激素相关不良事件的累计负荷

这是首个证明纵向应用糖皮质激素的剂量和强度与亚洲SLE队列的AE风险相关的研究。

BMJ:糖皮质激素可缓解喉咙疼痛?

2017年9月,发表在《BMJ》上的一项系统回顾和Meta分析,研究了糖皮质激素作为辅助疗法治疗喉咙痛的获益和危害。分析结果表明:单次低剂量糖皮质激素可缓解喉咙痛患者的疼痛,而不会增加严重不良反应。

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