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他汀类药物真的会引发糖尿病吗?对主要随机对照临床试验的荟萃分析。

Do statins really cause diabetes? A meta-analysis of major randomized controlled clinical trials.

作者信息

Rahal Alaa J, ElMallah Ahmed I, Poushuju Rita J, Itani Rana

机构信息

Department of Pharmacology and Therapeutics, Faculty of Pharmacy, Beirut Arab University, Beirut, Lebanon. E-mail.

出版信息

Saudi Med J. 2016 Oct;37(10):1051-60. doi: 10.15537/smj.2016.10.16078.

Abstract

OBJECTIVES

To investigate and establish the relationship between the use of statin therapy and the risk of development of diabetes.

METHODS

PubMed and the Cochrane Central Register of Controlled Trials was searched for randomized controlled end-point trials of statins, with more than 1000 subjects and a minimum of one-year follow-up period, published until August 2015. The odds ratio (OR) of diabetes incidence with overall statin therapy as well as with different statins in question was calculated through random effect meta-analysis model.

RESULTS

Fourteen studies were included in the analysis with a total of 94,943 participants. Of these, 2392 subjects developed incident diabetes in the statin and 2167 in the placebo groups during a 4-year follow-up. The OR of diabetes incidence with statin therapy was significantly higher as compared with the placebo group (OR=1.11; 95% confidence interval = 1.0 to 1.2; p=0.007). There was an insignificant level of heterogeneity between the included trials (Cochran Q= 19.463, p=0.109, I2=33.20). Subgroup analysis showed that only 2 statins namely, atorvastatin (OR= 1.29; p=0.042) and rosuvastatin (OR = 1.17; p=0.01) were significantly associated.

CONCLUSION

Statin therapy can slightly increase risk of incident diabetes in subjects with hypercholesterolemia.

摘要

目的

研究并确定他汀类药物治疗与糖尿病发生风险之间的关系。

方法

检索PubMed和Cochrane对照试验中央注册库,查找截至2015年8月发表的、受试者超过1000名且随访期至少一年的他汀类药物随机对照终点试验。通过随机效应荟萃分析模型计算总体他汀类药物治疗以及相关不同他汀类药物的糖尿病发病率比值比(OR)。

结果

分析纳入了14项研究,共有94943名参与者。其中,在4年随访期间,他汀类药物组有2392名受试者发生新发糖尿病,安慰剂组有2167名。与安慰剂组相比,他汀类药物治疗的糖尿病发病率OR显著更高(OR = 1.11;95%置信区间 = 1.0至1.2;p = 0.007)。纳入试验之间的异质性水平不显著(Cochran Q = 19.463,p = 0.109,I² = 33.20)。亚组分析显示,只有两种他汀类药物,即阿托伐他汀(OR = 1.29;p = 0.042)和瑞舒伐他汀(OR = 1.17;p = 0.01)有显著相关性。

结论

他汀类药物治疗可使高胆固醇血症患者发生新发糖尿病的风险略有增加。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2942/5075367/6346b4eda0ab/SaudiMedJ-37-1051-g001.jpg

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