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磺酰脲类药物在老年 2 型糖尿病患者中的应用与骨折风险:一项荟萃分析研究。

Sulfonylureas use and fractures risk in elderly patients with type 2 diabetes mellitus: a meta-analysis study.

机构信息

Department of Cardiology, The Seventh Affiliated Hospital, Sun Yat-Sen University, Shenzhen, China.

Yangzhou Center for Disease Control and Prevention, Yang Zhou, China.

出版信息

Aging Clin Exp Res. 2021 Aug;33(8):2133-2139. doi: 10.1007/s40520-020-01736-4. Epub 2020 Oct 26.

Abstract

BACKGROUND AND AIMS

Sulfonylureas are widely used in patients with type 2 diabetes; meanwhile, the increasing fractures risks especially in the old are gradually taken into consideration. This meta-analysis aimed at investigating whether sulfonylureas could influence the risk of fractures in type 2 diabetes (T2DM) in the elder patients (≥ 65 years old).

METHODS

We searched the PubMed and other databases to screen eligible studies. Two authors independently extracted data according to the selection criteria for each study. The Newcastle-Ottawa scale was used to evaluate the quality. Subgroups and sensitivity analyses were performed and publication bias was assessed.

RESULT

A total of 7 studies involving 464,121 individuals were included in our meta-analysis. The pooled risk ratio for developing fracture in sulfonylurea users with type 2 diabetes (≥ 65 years old) was 1.26 (95% CI 1.15-1.39). Sensitivity analyses confirmed the stability of the results and there was no publication bias.

CONCLUSIONS

Sulfonylureas could add the risk of fractures among the old with type 2 diabetes. Initial sulfonylureas therapy in both men and women should be done prudently.

摘要

背景与目的

磺酰脲类药物广泛用于 2 型糖尿病患者;与此同时,老年人骨折风险增加的问题也逐渐受到关注。本荟萃分析旨在探讨磺酰脲类药物是否会影响老年(≥65 岁)2 型糖尿病患者的骨折风险。

方法

我们检索了 PubMed 和其他数据库,以筛选合格的研究。两位作者根据每项研究的选择标准独立提取数据。使用纽卡斯尔-渥太华量表评估质量。进行了亚组和敏感性分析,并评估了发表偏倚。

结果

共有 7 项研究纳入了 464121 名患者,其中包括磺酰脲类药物使用者和 2 型糖尿病(≥65 岁)患者。磺酰脲类药物使用者发生骨折的风险比为 1.26(95%CI 1.15-1.39)。敏感性分析证实了结果的稳定性,且不存在发表偏倚。

结论

磺酰脲类药物可能会增加老年 2 型糖尿病患者的骨折风险。在男性和女性中,初始磺酰脲类药物治疗应谨慎进行。

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