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抗高血压药物引发新发糖尿病的比较风险:一项网状Meta分析。

Comparative risk of new-onset diabetes mellitus for antihypertensive drugs: A network meta-analysis.

作者信息

Li Zimeng, Li Yi, Liu Yulong, Xu Wenbo, Wang Qing

机构信息

Department of Endocrinology, China-Japan Union Hospital of Jilin University, Changchun, China.

Department of Radiology, China-Japan Union Hospital of Jilin University, Changchun, China.

出版信息

J Clin Hypertens (Greenwich). 2017 Dec;19(12):1348-1356. doi: 10.1111/jch.13108. Epub 2017 Oct 25.

Abstract

New-onset diabetes mellitus (NOD) refers to forms of diabetes mellitus that develop during the therapeutic processes of other diseases such as hypertension. This study has been conducted in a network meta-analysis to compare antihypertensive drugs by identifying both the advantages and disadvantages on NOD by focusing on their respective effect rates. Odd ratios and corresponding 95% confidence intervals or credible intervals were calculated within pairwise and network meta-analysis. A total of 38 articles with 224 140 patients were included to evaluate the preventive effect of hypertension drugs on NOD. From the network meta-analysis it was evident that both angiotensin-converting enzyme inhibitor as well as angiotensin receptor blocker treatments are associated with a lower risk of developing NOD compared with placebo, with ranking probabilities of 79.81% and 72.77%, respectively, while β-blockers and calcium channel blockers may significantly increase the probability of developing NOD (β-blockers: odds ratio, 2.18 [95% credible intervals: 1.36-3.50]; calcium channel blockers: odds ratio, 1.16 [95% credible intervals, 1.05-1.29]). In conclusion, angiotensin receptor blockers have an advantage over the other treatments regarding the NOD.

摘要

新发糖尿病(NOD)是指在诸如高血压等其他疾病的治疗过程中发生的糖尿病类型。本研究通过网络荟萃分析进行,旨在通过关注各类降压药物导致NOD的发生率,来比较它们的优缺点,识别其各自的优劣之处。在成对分析和网络荟萃分析中计算了比值比及相应的95%置信区间或可信区间。总共纳入了38篇文章,涉及224140名患者,以评估高血压药物对NOD的预防效果。从网络荟萃分析中可以明显看出,与安慰剂相比,血管紧张素转换酶抑制剂和血管紧张素受体阻滞剂治疗发生NOD的风险较低,其排序概率分别为79.81%和72.77%,而β受体阻滞剂和钙通道阻滞剂可能会显著增加发生NOD的概率(β受体阻滞剂:比值比为2.18 [95%可信区间:1.36 - 3.50];钙通道阻滞剂:比值比为1.16 [95%可信区间:1.05 - 1.29])。总之,在新发糖尿病方面,血管紧张素受体阻滞剂比其他治疗方法具有优势。

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