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患有和不患有糖尿病的老年人之间的多重用药差异:来自英国老龄化纵向研究的证据。

Polypharmacy difference between older people with and without diabetes: Evidence from the English longitudinal study of ageing.

机构信息

Department of Epidemiology and Public Health, University College London, London, UK.

Department of Behavioural Science and Health, University College London, London, UK.

出版信息

Diabetes Res Clin Pract. 2021 Jun;176:108842. doi: 10.1016/j.diabres.2021.108842. Epub 2021 Apr 30.

Abstract

AIM

To study the association between diabetes and the prevalence of and risk factors for polypharmacy among adults aged 50 and older in England.

METHODS

A cross-sectional study (2012-2013) of the English Longitudinal Study of Ageing. Polypharmacy was defined as taking 5-9 long-term medications a day and heightened polypharmacy as 10 or more. Diabetes included diagnosed and undiagnosed cases (glycated haemoglobin ≥ 6.5% (48 mmol/mol)).

RESULTS

Of 7729 participants, 1100 people had diabetes and showed higher prevalence rates of polypharmacy (41.1% vs 14.8%) and heightened polypharmacy (5.8% vs 1.7%) than those without diabetes, even when antihyperglycemic medications were excluded. Risk factors for polypharmacy also differed according to diabetes status. Among people with diabetes, risk factors for polypharmacy and heightened polypharmacy were having more long-term conditions (relative risk ratio (RRR) = 1.86; 3.51) and being obese (RRR = 1.68; 3.68), while females were less likely to show polypharmacy (RRR = 0.51) and heightened polypharmacy (RRR = 0.51) than males. Older age (RRR = 1.04) was only related to polypharmacy among people without diabetes.

CONCLUSIONS

Adults with diabetes had higher prevalence rates of polypharmacy and heightened polypharmacy than those without diabetes, regardless of including antihyperglycemic drugs. Early detection of polypharmacy among older people with diabetes needs to focus on co-morbidities and obesity.

摘要

目的

研究英格兰 50 岁及以上成年人中糖尿病与多药治疗的流行率和危险因素之间的关系。

方法

一项对英国老龄化纵向研究(2012-2013 年)的横断面研究。多药治疗定义为每天服用 5-9 种长期药物,高度多药治疗定义为 10 种或更多。糖尿病包括已确诊和未确诊的病例(糖化血红蛋白≥6.5%(48mmol/mol))。

结果

在 7729 名参与者中,1100 人患有糖尿病,其多药治疗(41.1%比 14.8%)和高度多药治疗(5.8%比 1.7%)的患病率均高于无糖尿病者,即使排除了降血糖药物。多药治疗的危险因素也因糖尿病状况而异。在患有糖尿病的人群中,多药治疗和高度多药治疗的危险因素包括患有更多的长期疾病(相对风险比(RRR)=1.86;3.51)和肥胖(RRR=1.68;3.68),而女性发生多药治疗(RRR=0.51)和高度多药治疗(RRR=0.51)的可能性低于男性。年龄较大(RRR=1.04)仅与无糖尿病者的多药治疗有关。

结论

无论是否包括降血糖药物,患有糖尿病的成年人的多药治疗和高度多药治疗的患病率均高于无糖尿病者。在患有糖尿病的老年人中,早期发现多药治疗需要重点关注共病和肥胖。

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