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2 型糖尿病患者尿路感染的发生率。来自临床试验不良事件报告的经验。

Incidence of urinary tract infection in patients with type 2 diabetes. Experience from adverse event reporting in clinical trials.

机构信息

Department of Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.

出版信息

Pharmacoepidemiol Drug Saf. 2010 Dec;19(12):1287-92. doi: 10.1002/pds.2043. Epub 2010 Oct 21.

Abstract

PURPOSE

Diabetes mellitus has long been widely considered to be associated with an increased risk of urinary tract infection (UTI), but information on incidence rates are scarce and risk factor data have been conflicting. The aim was to estimate UTI incidence and evaluate potential risk factors for UTI in patients with type 2 diabetes included in recent clinical trials.

METHODS

Type 2 diabetes patients from 10 AstraZeneca phase III diabetes clinical trials (n=6016, mean 57.4 years, 50.7% female) conducted during 2004-2007 were included. Patients free of UTI at baseline were followed for up to 6 months after inclusion in the trials. UTI was considered present if any term sorting under the MedDRA high-level term "UTIs" was recorded as an adverse event.

RESULTS

In all, 142 patients had an adverse event for UTI, corresponding to an incidence of 59.5/1000 person-years for all patients (91.5/1000 in women, 28.2/1000 in men) and a cumulative incidence of 2% during 6 months. Female gender was associated with an increased incidence [relative risk (RR) 3.4; 95% confidence interval (CI) 2.3-5.1] and also higher age (RR 2.5 [95% CI 1.4-4.8] for ages ≥ 70 years vs. 40-49 years). No increased incidence was associated with body mass index (25-29, 30+ vs. <25 kg/m(2) ), HbA1c (<8% vs. >8%), race (Black, Oriental vs. Caucasian) or drug treatment (study drug, comparator vs. placebo). A history of immune system disorder conveyed a twofold higher risk for UTI.

CONCLUSION

UTI is common among female patients with type 2 diabetes and older patients of both genders.

摘要

目的

糖尿病长期以来被广泛认为与尿路感染(UTI)风险增加有关,但发病率信息稀缺,且风险因素数据相互矛盾。本研究旨在评估近期临床试验中纳入的 2 型糖尿病患者的 UTI 发病率,并评估 UTI 的潜在危险因素。

方法

纳入了来自阿斯利康(AstraZeneca)10 项 2 型糖尿病 III 期临床试验的患者(n=6016,平均年龄 57.4 岁,50.7%为女性),这些试验于 2004 年至 2007 年进行。基线时无 UTI 的患者在入组试验后最多随访 6 个月。如果任何 MedDRA 高级术语“UTIs”下的术语被记录为不良事件,则认为存在 UTI。

结果

共有 142 例患者发生 UTI 不良事件,所有患者的发病率为 59.5/1000 人年(女性为 91.5/1000,男性为 28.2/1000),6 个月时累积发病率为 2%。女性与发病率增加相关(相对风险 [RR] 3.4;95%置信区间 [CI] 2.3-5.1),年龄较高也与发病率增加相关(年龄≥70 岁与 40-49 岁相比,RR 2.5[95%CI 1.4-4.8])。体重指数(25-29、30+与<25kg/m²)、糖化血红蛋白(HbA1c)(<8%与>8%)、种族(黑人、东方人与白人)或药物治疗(研究药物、对照药物与安慰剂)与发病率增加无关。免疫系统疾病史使 UTI 的风险增加了两倍。

结论

UTI 在女性 2 型糖尿病患者和各年龄段的男性患者中较为常见。

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