Lee Hee Jeong, Lee Haekyung, Oh Song Hee, Park Suyeon, Jung Kwang-Young, Kim Hyoungnae, Kwon Soon Hyo, Jeon Jin Seok, Han Dong Cheol, Noh Hyunjin
Division of Nephrology, Department of Internal Medicine, Soon Chun Hyang University, 59 Daesagwan-ro, Yongsan-gu, Seoul 04401, Korea.
Department of Biostatistics, Soon Chun Hyang University Seoul Hospital, 59 Daesagwan-ro, Yongsan-gu, Seoul 04401, Korea.
J Clin Med. 2019 Jul 31;8(8):1145. doi: 10.3390/jcm8081145.
Beta2-adrenergic receptor (β2AR) agonists can have protective effects targeting macrophage activation, but research on human subjects has not been done. This study was designed to assess the relationship between the use of β2AR agonists and diabetic vascular complications. Using data from the Korean National Health Insurance Service, adults first diagnosed with diabetes in 2004 (n = 249,222) were followed up until 31 December 2015. Propensity score matching was performed between case and control groups (n = 5179 in each), and multivariate analysis was conducted. The β2AR agonist group was divided into quartiles according to the duration of β2AR agonist use. During the follow-up, the incidence of vascular complications gradually decreased as the duration of β2AR agonist administration increased. Multivariate analysis revealed that the hazard ratio for all composite vascular complications was 0.80 (95% CI, 0.75-0.86, < 0.001) in the longest quartile of β2AR agonist use as compared with the control group after adjusting for confounding variables. The association between the duration of β2AR agonist use and the risk of each vascular complication including cerebrovascular, peripheral vascular, peripheral neural, renal, and ophthalmic complications was consistent, and the risks were significantly lower in the longest users than the control group. Long-term use of β2AR agonists may exert a protective effect against diabetic vascular complications.
β2肾上腺素能受体（β2AR）激动剂可针对巨噬细胞激活发挥保护作用，但尚未对人体进行相关研究。本研究旨在评估β2AR激动剂的使用与糖尿病血管并发症之间的关系。利用韩国国民健康保险服务的数据，对2004年首次诊断为糖尿病的成年人（n = 249,222）进行随访，直至2015年12月31日。在病例组和对照组（每组n = 5179）之间进行倾向评分匹配，并进行多变量分析。β2AR激动剂组根据β2AR激动剂的使用时长分为四分位数。在随访期间，随着β2AR激动剂给药时长的增加，血管并发症的发生率逐渐降低。多变量分析显示，在调整混杂变量后，与对照组相比，β2AR激动剂使用时长最长的四分位数组中所有复合血管并发症的风险比为0.80（95%CI，0.75 - 0.86，< 0.001）。β2AR激动剂使用时长与包括脑血管、外周血管、外周神经、肾脏和眼科并发症在内的每种血管并发症风险之间的关联是一致的，使用时长最长的人群的风险显著低于对照组。长期使用β2AR激动剂可能对糖尿病血管并发症发挥保护作用。
