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他汀类药物治疗与成年女性患糖尿病的风险:益处是否大于风险?

Statin therapy and the risk for diabetes among adult women: do the benefits outweigh the risk?

作者信息

Ma Yunsheng, Culver Annie, Rossouw Jacques, Olendzki Barbara, Merriam Philip, Lian Bill, Ockene Ira

机构信息

Associate Professor of Medicine, Division of Preventive and Behavioral Medicine, Department of Medicine, University of Massachusetts Medical School, 55 Lake Avenue North, Worcester, MA 01655, USA.

出版信息

Ther Adv Cardiovasc Dis. 2013 Feb;7(1):41-4. doi: 10.1177/1753944712468499. Epub 2012 Dec 13.

DOI:10.1177/1753944712468499
PMID:23238515
Abstract

PURPOSE OF REVIEW

The purpose of this review was to examine statin therapy and the risk for diabetes among adult women using a selective review.

RECENT FINDINGS

The literature contains reports of new-onset diabetes associated with statin use. While many studies do not report sex-specific results, there is evidence indicating the risk to benefit ratio may vary by gender. However, the absolute effects are not clear because women have historically been under-represented in clinical trials.

SUMMARY

A review of the literature indicates that the cardiovascular benefits of statins appear to outweigh the risk for statin-related diabetes. However, the effect may depend upon baseline diabetes risk, dose, and statin potency. Rigorous, long-term studies focused on the risks and benefits of statins in women are unavailable to sort for gender-specific differences. Until this changes, individualized attention to risk assessment, and strong prevention with lifestyle changes must prevail.

摘要

综述目的

本综述旨在通过选择性回顾研究他汀类药物治疗与成年女性患糖尿病风险之间的关系。

最新研究发现

文献中有关于他汀类药物使用与新发糖尿病相关的报道。虽然许多研究未报告性别特异性结果,但有证据表明风险效益比可能因性别而异。然而,由于历史上女性在临床试验中的代表性不足,绝对影响尚不清楚。

总结

文献综述表明,他汀类药物对心血管的益处似乎超过了与他汀类药物相关的糖尿病风险。然而,这种影响可能取决于基线糖尿病风险、剂量和他汀类药物的效力。目前尚无针对他汀类药物在女性中的风险和益处的严格长期研究来区分性别特异性差异。在此情况改变之前,必须优先对风险评估给予个性化关注,并通过改变生活方式进行有力预防。

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Acad Pediatr. 2017 Jul;17(5):515-522. doi: 10.1016/j.acap.2017.02.006. Epub 2017 Feb 21.
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Communicating statin evidence to support shared decision-making.传达他汀类药物的证据以支持共同决策。
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Strategies for improving cardiovascular health in women with diabetes mellitus: a review of the evidence.改善糖尿病女性心血管健康的策略:证据综述
Curr Diab Rep. 2015 Nov;15(11):98. doi: 10.1007/s11892-015-0665-7.
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Statins and Cataracts--a visual insight.他汀类药物与白内障——视觉洞察
Curr Atheroscler Rep. 2015;17(2):477. doi: 10.1007/s11883-014-0477-2.
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Development of reusable logic for determination of statin exposure-time from electronic health records.开发用于从电子健康记录中确定他汀类药物暴露时间的可重复使用逻辑。
J Biomed Inform. 2014 Jun;49:206-12. doi: 10.1016/j.jbi.2014.02.014. Epub 2014 Mar 15.
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Benefits & risks of statin therapy for primary prevention of cardiovascular disease in Asian Indians - a population with the highest risk of premature coronary artery disease & diabetes.他汀类药物治疗对亚洲印度人进行心血管疾病一级预防的益处与风险——亚洲印度人是冠心病和糖尿病过早发病风险最高的人群。
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