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他汀类药物的使用与勃起功能障碍的发生——台湾一项全国性倾向匹配队列研究

Statin use and incident erectile dysfunction--A nationwide propensity-matched cohort study in Taiwan.

作者信息

Chou Chian-Ying, Yang Yi-Fan, Chou Yiing-Jenq, Hu Hsiao-Yun, Huang Nicole

机构信息

Institute of Public Health & Department of Public Health, National Yang Ming University, Taipei, Taiwan.

Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.

出版信息

Int J Cardiol. 2016 Jan 1;202:883-8. doi: 10.1016/j.ijcard.2015.10.012. Epub 2015 Oct 9.

Abstract

BACKGROUND

Statins are commonly prescribed for cardiovascular diseases which have been reported to share many contributory underlying mechanisms with erectile dysfunction (ED). However, the correlation between statin use and incident ED is uncertain.

METHODS

We conducted a population-based propensity-matched cohort study by identifying new statin users among male patients 40-79 years of age in the period 2000 to 2010. A statin nonuser control cohort matched for age, propensity score, and index year at a 3:1 ratio was selected for comparison. Cohorts were tracked for the occurrence of any type of incident ED according to the registry of ED diagnosis in the database. The association between statin use and the risk of ED was evaluated by Cox proportional hazard model and adjusted by age, PS, socioeconomic status, comorbidities, and medications.

RESULTS

Compared with nonusers, statin users had a significantly lower risk of incident ED (HR, 0.75; 95% CI, 0.63-0.90, p=0.002). Further analysis demonstrated that statin users in the group of middle-aged (40-49 years old) or high-potency statin treated (i.e., rosuvastatin, atorvastatin, and simvastatin) had lower HR for incident ED. Analysis in the patterns of cumulative statin exposure also showed that high-potency statins could decrease the HR for incident ED in dose- and duration-dependent manners.

CONCLUSIONS

Statin use was associated with a reduced risk of incident ED in the middle-aged men in Taiwan. The potency and the cumulative exposure of statin utilized played critical roles.

摘要

背景

他汀类药物常用于治疗心血管疾病,据报道,心血管疾病与勃起功能障碍(ED)有许多共同的潜在发病机制。然而,他汀类药物的使用与新发ED之间的相关性尚不确定。

方法

我们进行了一项基于人群的倾向匹配队列研究,在2000年至2010年期间,在40 - 79岁的男性患者中识别新使用他汀类药物的患者。选择一个年龄、倾向得分和索引年份相匹配的非他汀类药物使用者对照队列,比例为3:1进行比较。根据数据库中ED诊断记录跟踪队列中任何类型新发ED的发生情况。通过Cox比例风险模型评估他汀类药物使用与ED风险之间的关联,并根据年龄、PS、社会经济状况、合并症和药物进行调整。

结果

与未使用者相比,他汀类药物使用者发生新发ED的风险显著降低(HR,0.75;95%CI,0.63 - 0.90,p = 0.002)。进一步分析表明,中年(40 - 49岁)或接受高效能他汀类药物治疗(即瑞舒伐他汀、阿托伐他汀和辛伐他汀)的他汀类药物使用者发生新发ED的HR较低。对他汀类药物累积暴露模式的分析还表明,高效能他汀类药物可以以剂量和持续时间依赖的方式降低新发ED的HR。

结论

在台湾中年男性中,使用他汀类药物与新发ED风险降低有关。所使用他汀类药物的效能和累积暴露起着关键作用。

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