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他汀类药物使用对糖尿病患者结核病发生发展的影响。

The effects of statin use on the development of tuberculosis among patients with diabetes mellitus.

作者信息

Kang Y A, Choi N-K, Seong J-M, Heo E Y, Koo B K, Hwang S-S, Park B-J, Yim J-J, Lee C-H

机构信息

Division of Pulmonology, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea.

Medical Research Collaborating Center, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Republic of Korea.

出版信息

Int J Tuberc Lung Dis. 2014 Jun;18(6):717-24. doi: 10.5588/ijtld.13.0854.

Abstract

OBJECTIVE

To evaluate whether statin use affects the development of tuberculosis (TB) among patients with diabetes mellitus (DM).

METHODS

This is a retrospective cohort study of patients with newly diagnosed type 2 DM based on the South Korean nationwide claims database. The participants were type 2 DM patients aged 20-99 years who were newly treated with anti-diabetic drugs between 1 January 2007 and 31 December 2010. Patients who had statin prescriptions before a diagnosis of diabetes or were diagnosed with TB before diabetes were excluded.

RESULTS

Of 840,899 newly diagnosed type 2 DM patients, 281,842 (33.5%) patients were statin users and 559,057 (66.5%) were non-users. During the study period, 4075 [corrected] individuals were diagnosed with TB; the estimated incidence of TB in our cohort was 251/100,000 patient-years (95%CI 243-258). In comparison to non-TB patients, statin users were less frequent among TB patients (19.2% vs. 33.6%). After adjustment for potential baseline confounders, statin use was not associated with the development of TB in DM patients (aHR 0.98; 95%CI 0.89-1.07).

CONCLUSIONS

TB development among newly diagnosed type 2 DM was considerable, and statin use among these diabetics was not associated with a protective effect on TB incidence.

摘要

目的

评估他汀类药物的使用是否会影响糖尿病(DM)患者中结核病(TB)的发生。

方法

这是一项基于韩国全国索赔数据库的新诊断2型糖尿病患者的回顾性队列研究。参与者为20 - 99岁的2型糖尿病患者,他们在2007年1月1日至2010年12月31日期间开始接受抗糖尿病药物新治疗。排除在糖尿病诊断之前有他汀类药物处方或在糖尿病之前被诊断为结核病的患者。

结果

在840,899例新诊断的2型糖尿病患者中,281,842例(33.5%)患者使用他汀类药物,559,057例(66.5%)患者未使用。在研究期间,4075例[校正后]个体被诊断为结核病;我们队列中结核病的估计发病率为251/100,000患者年(95%CI 243 - 258)。与非结核病患者相比,结核病患者中他汀类药物使用者较少(19.2%对33.6%)。在对潜在的基线混杂因素进行调整后,他汀类药物的使用与糖尿病患者结核病的发生无关(调整后风险比0.98;95%CI 0.89 - 1.07)。

结论

新诊断的2型糖尿病患者中结核病的发生率较高,这些糖尿病患者使用他汀类药物对结核病发病率没有保护作用。

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