强效他汀类药物对糖尿病患者及非糖尿病患者糖化血红蛋白（HbA1c）的影响。
Effect of high-potency statins on HbA1c in patients with or without diabetes mellitus.
作者信息
Ooba Nobuhiro, Tanaka Shoutarou, Yasukawa Yu, Yoshino Nariyasu, Hayashi Hiroyuki, Hidaka Shinji, Seki Toshiichi, Fukuoka Noriyasu
机构信息
Department of Clinical Pharmacy, The Nihon University School of Pharmacy, 7-7-1 Narashinodai, Funabashi-shi, Chiba 274-8555 Japan.
Department of Pharmacotherapy, The Nihon University School of Pharmacy, 7-7-1 Narashinodai, Funabashi-shi, Chiba 274-8555 Japan.
出版信息
J Pharm Health Care Sci. 2016 Mar 18;2:8. doi: 10.1186/s40780-016-0040-0. eCollection 2016.
BACKGROUND
The increased risk of new-onset diabetes with statin use, including high-potency statins, is well known. However, the effects of high-potency statins on HbA1c are unclear. A retrospective cohort study was conducted to examine the effect of high-potency statins on HbA1c in patients with or without diabetes. The study enrolled new statin users identified via the electronic healthcare database of the general hospital in Japan.
METHODS
Following identification of all individuals (n = 4,672) who had been prescribed a lipid lowering drug at least once between January 1, 2010 and July 31, 2014, new statin users were selected (n = 1,136). Patients were excluded if they had been prescribed treatment with a statin within the preceding 6-month period. HbA1c levels before and during high-potency statin treatment were compared using the dependent t-test. In addition, the hazard ratio for the incidence of diabetes with high-potency statin treatment was estimated, using low-potency statins as a reference.
RESULTS
In patients with diabetes (n = 153), mean HbA1c (%) levels significantly increased by 0.4 % after high-potency statin use (7.57 ± 1.58; p = 0.0002) compared to baseline (7.18 ± 1.37). Similarly, HbA1c (%) levels significantly increased from 5.78 ± 0.38 to 5.92 ± 0.45 (p < 0.0001) after high-potency statin use in patients without diabetes (n = 165). Furthermore, a trend toward an increase in HbA1c was found for all of the high-potency statins irrespective of a history of diabetes.
CONCLUSIONS
The use of high-potency statins may increase HbA1c levels in patients with or without diabetes.
背景
使用他汀类药物（包括高强度他汀类药物）会增加新发糖尿病的风险，这一点已广为人知。然而，高强度他汀类药物对糖化血红蛋白（HbA1c）的影响尚不清楚。本研究进行了一项回顾性队列研究，以探讨高强度他汀类药物对糖尿病患者和非糖尿病患者HbA1c的影响。该研究纳入了通过日本综合医院电子医疗数据库识别出的新使用他汀类药物的患者。
方法
在确定了2010年1月1日至2014年7月31日期间至少接受过一次降脂药物治疗的所有个体（n = 4,672）之后，选择了新使用他汀类药物的患者（n = 1,136）。如果患者在过去6个月内曾接受过他汀类药物治疗，则将其排除。使用配对t检验比较高强度他汀类药物治疗前和治疗期间的HbA1c水平。此外，以低强度他汀类药物作为对照，估计高强度他汀类药物治疗糖尿病发病率的风险比。
结果
在糖尿病患者（n = 153）中，与基线水平（7.18±1.37）相比，使用高强度他汀类药物后糖化血红蛋白（HbA1c）平均水平显著升高了0.4%（7.57±1.58；p = 0.0002）。同样，在非糖尿病患者（n = 165）中，使用高强度他汀类药物后，HbA1c水平也从5.78±0.38显著升高至5.92±0.45（p < 0.0001）。此外，无论有无糖尿病史，所有高强度他汀类药物均呈现HbA1c升高的趋势。
结论
使用高强度他汀类药物可能会使糖尿病患者和非糖尿病患者的HbA1c水平升高。
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