Policardo Laura, Seghieri Giuseppe, Anichini Roberto, Francesconi Paolo
Epidemiology Unit, Agenzia Regionale Sanità Toscana, Via Pietro Dazzi 1, 50141, Florence, Italy.
Diabetes Unit, Ospedale S. Jacopo, Pistoia, Italy.
Acta Diabetol. 2017 Jul;54(7):669-675. doi: 10.1007/s00592-017-0990-1. Epub 2017 Apr 18.
To investigate whether statins reduce the risk to first hospitalization of bacterial infections, in patients with or without diabetes taking into account prior or incident comorbidities.
By using administrative databases, the effect of current statin use was measured on the risk of first hospitalizations due to bacterial infections in people living in Tuscany, Italy, in the period January 1, 2011-December 31, 2015, after excluding those with previous statins use. Population was stratified as with (n = 128,207) or without diabetes (n = 3,304,906), and the hospitalization risk was analyzed by a Cox proportional hazards regression analysis after adjusting for age, gender, previous comorbidities, chronic renal failure, and prior or incident cardiovascular diseases.
During the 5-year follow-up, 31,543 hospitalizations for bacterial infections were observed: 2.08(2.06-2.10) per 1000 person-year in non-diabetic and 5679: 9.13(8.94-9.32) per 1000 person-year in diabetic population. Diabetes conferred a greater risk of hospitalizations, independently from confounders [adjusted HR (95% CI) 2.04 (1.97-2.10); P < 0.0001]. Statin use decreased the risk by about 2.5% for each one month of therapy, at the same extent in subjects with or without diabetes, after adjusting for all covariates.
In this population, diabetes was associated by a twofold increase in the 5-year risk of hospitalizations for bacterial infections. Statin use decreased this risk to a same extent in subjects without or with diabetes, after adjusting for main confounders including comorbidities, and previous or incident cardiovascular events.
研究他汀类药物是否能降低有或无糖尿病患者首次因细菌感染住院的风险,并考虑既往或新发的合并症。
利用管理数据库,在排除既往使用过他汀类药物的患者后,测量2011年1月1日至2015年12月31日期间意大利托斯卡纳地区居民当前使用他汀类药物对首次因细菌感染住院风险的影响。将人群分为有糖尿病(n = 128,207)和无糖尿病(n = 3,304,906)两组,并在调整年龄、性别、既往合并症、慢性肾衰竭以及既往或新发心血管疾病后,通过Cox比例风险回归分析住院风险。
在5年随访期间,观察到31,543例因细菌感染住院:非糖尿病患者每1000人年为2.08(2.06 - 2.10)例,糖尿病患者为5679例,每1000人年为9.13(8.94 - 9.32)例。糖尿病独立于混杂因素增加了住院风险[调整后风险比(95%置信区间)2.04(1.97 - 2.10);P < 0.0001]。在调整所有协变量后,他汀类药物的使用使风险每月降低约2.5%,在有或无糖尿病的受试者中降低程度相同。
在该人群中,糖尿病与5年内因细菌感染住院风险增加两倍相关。在调整包括合并症以及既往或新发心血管事件等主要混杂因素后,他汀类药物的使用在无糖尿病或有糖尿病的受试者中同等程度地降低了这种风险。