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苯溴马隆可降低痛风患者糖尿病的发病率。

Decreased incidence of diabetes in patients with gout using benzbromarone.

机构信息

Division of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.

Department of Internal Medicine, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung, Taiwan.

出版信息

Rheumatology (Oxford). 2018 Sep 1;57(9):1574-1582. doi: 10.1093/rheumatology/key138.

Abstract

OBJECTIVE

Insulin resistance is inversely correlated with the clearance rate of uric acid, which may indicate that improvement in the clearance rate of uric acid could reduce insulin resistance. Considering the increased prevalence of diabetes mellitus (DM) in the gout population, this study evaluated the effects of benzbromarone, a uricosuric agent, on the incidence of DM in the gout population.

METHODS

We used data from the Taiwan National Health Insurance program. The benzbromarone user cohort included 8678 patients; each patient was age- and sex-matched with one benzbromarone non-user who was randomly selected from the gout population. The Cox proportional hazard regression analysis was conducted to estimate the effects of benzbromarone on the incidence of DM in the gout population.

RESULTS

The incidence of DM was significantly lower in benzbromarone users than in benzbromarone non-users [adjusted hazard ratio (HR) = 0.86; 95% CI: 0.79, 0.94]. The HR for the incidence of DM was lower in male benzbromarone users (adjusted HR = 0.77; 95% CI: 0.69, 0.86) than in benzbromarone non-users. An analysis of three age groups (<40, 40-59 and ⩾60 years) indicated that the HRs of the age groups of 40-59 years (adjusted HR = 0.86; 95% CI: 0.76, 0.98) and ⩾60 years (adjusted HR = 0.82; 95% CI: 0.71, 0.94) were significantly lower among benzbromarone users than among benzbromarone non-users.

CONCLUSION

In the gout population, the incidence of DM was lower in benzbromarone users than in benzbromarone non-users.

摘要

目的

尿酸清除率与胰岛素抵抗呈负相关,这表明尿酸清除率的提高可能会降低胰岛素抵抗。鉴于痛风人群中糖尿病(DM)的患病率增加,本研究评估了苯溴马隆(一种促进尿酸排泄的药物)对痛风人群中 DM 发生率的影响。

方法

我们使用了来自台湾全民健康保险计划的数据。苯溴马隆使用者队列包括 8678 名患者;每位患者与一名随机从痛风人群中选择的苯溴马隆非使用者按年龄和性别匹配。采用 Cox 比例风险回归分析来评估苯溴马隆对痛风人群中 DM 发生率的影响。

结果

与苯溴马隆非使用者相比,苯溴马隆使用者的 DM 发生率显著降低[调整后的危险比(HR)=0.86;95%可信区间:0.79,0.94]。男性苯溴马隆使用者的 DM 发生率(调整 HR = 0.77;95%可信区间:0.69,0.86)低于苯溴马隆非使用者。对三个年龄组(<40 岁、40-59 岁和 ⩾60 岁)的分析表明,40-59 岁年龄组(调整 HR = 0.86;95%可信区间:0.76,0.98)和 ⩾60 岁年龄组(调整 HR = 0.82;95%可信区间:0.71,0.94)的 HR 明显低于苯溴马隆非使用者。

结论

在痛风人群中,苯溴马隆使用者的 DM 发生率低于苯溴马隆非使用者。

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