Wasko Mary Chester M, Hubert Helen B, Lingala Vijaya Bharathi, Elliott Jennifer R, Luggen Michael E, Fries James F, Ward Michael M
Division of Rheumatology and Clinical Immunology, University of Pittsburgh, Pittsburgh, Pennsylvania 15261, USA.
JAMA. 2007 Jul 11;298(2):187-93. doi: 10.1001/jama.298.2.187.
Hydroxychloroquine, a commonly used antirheumatic medication, has hypoglycemic effects and may reduce the risk of diabetes mellitus.
To determine the association between hydroxychloroquine use and the incidence of self-reported diabetes in a cohort of patients with rheumatoid arthritis.
DESIGN, SETTING, AND PATIENTS: A prospective, multicenter observational study of 4905 adults with rheumatoid arthritis (1808 had taken hydroxychloroquine and 3097 had never taken hydroxychloroquine) and no diagnosis or treatment for diabetes in outpatient university-based and community-based rheumatology practices with 21.5 years of follow-up (January 1983 through July 2004).
Diabetes by self-report of diagnosis or hypoglycemic medication use.
During the observation period, incident diabetes was reported by 54 patients who had taken hydroxychloroquine and by 171 patients who had never taken hydroxychloroquine, with incidence rates of 5.2 per 1000 patient-years of observation compared with 8.9 per 1000 patient-years of observation, respectively (P < .001). In time-varying multivariable analysis with adjustments for possible confounding factors, the hazard ratio for incident diabetes among patients who had taken hydroxychloroquine was 0.62 (95% confidence interval, 0.42-0.92) compared with those who had not taken hydroxychloroquine. In Poisson regression, the risk of incident diabetes was significantly reduced with increased duration of hydroxychloroquine use (P < .001 for trend); among those taking hydroxychloroquine for more than 4 years (n = 384), the adjusted relative risk of developing diabetes was 0.23 (95% confidence interval, 0.11-0.50; P < .001), compared with those who had not taken hydroxychloroquine.
Among patients with rheumatoid arthritis, use of hydroxychloroquine is associated with a reduced risk of diabetes.
羟氯喹是一种常用的抗风湿药物，具有降血糖作用，可能降低糖尿病风险。
确定类风湿关节炎患者队列中羟氯喹使用与自我报告的糖尿病发病率之间的关联。
设计、地点和患者：一项前瞻性、多中心观察性研究，纳入4905例成年类风湿关节炎患者（1808例服用过羟氯喹，3097例从未服用过羟氯喹），这些患者在以大学为基础的门诊和社区风湿病诊所中未被诊断或治疗过糖尿病，随访21.5年（1983年1月至2004年7月）。
通过自我报告诊断或使用降糖药物来确定糖尿病。
在观察期内，服用羟氯喹的患者中有54例报告发生糖尿病，未服用羟氯喹的患者中有171例报告发生糖尿病，发病率分别为每1000患者年观察期5.2例和8.9例（P <.001）。在对可能的混杂因素进行调整的时变多变量分析中，服用羟氯喹的患者发生糖尿病的风险比未服用羟氯喹的患者为0.62（95%置信区间，0.42 - 0.92）。在泊松回归中，随着羟氯喹使用时间的延长，发生糖尿病的风险显著降低（趋势P <.001）；在服用羟氯喹超过4年的患者（n = 384）中，与未服用羟氯喹的患者相比，发生糖尿病的调整后相对风险为0.23（95%置信区间，0.11 - 0.50；P <.001）。
在类风湿关节炎患者中，使用羟氯喹与糖尿病风险降低有关。
