Department of Biostatistics, Epidemiology and Informatics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA.
Department of Biostatistics, Epidemiology and Informatics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA.
Diabetes Res Clin Pract. 2022 Mar;185:109225. doi: 10.1016/j.diabres.2022.109225. Epub 2022 Feb 3.
Fluoroquinolone antibiotics have been implicated in cases of metabolic adverse events. This study investigated the causal association between fluoroquinolones and serious hypoglycemia in those with and without diabetes.
We conducted a propensity score-matched cohort study using Optum claims data. We included adults dispensed an oral fluoroquinolone or comparator antibiotic between January 2000 and September 2015 for specific infections of interest. The outcome was serious hypoglycemia, defined using a validated algorithm. Conditional logistic regression was used to estimate odds ratios (ORs) in diabetes and non-diabetes cohorts after matching on propensity scores fitted using confounding variables of interest.
Our cohort contained 119,112 individuals with diabetes and 917,867 individuals without diabetes exposed to a fluoroquinolone, matched 1:1 with a comparator. Matching produced balance (standardized mean difference < 0.1) on all variables included in the propensity score. The OR for the association between fluoroquinolones and serious hypoglycemia was 1.28 (95% confidence interval [CI]: 1.04-1.57) in the entire cohort, 1.30 (95% CI: 1.05-1.62) in individuals with diabetes, and 1.06 (95% CI: 0.53-2.13) in individuals without diabetes.
Fluoroquinolone users are at an increased risk of serious hypoglycemia relative to comparator antibiotic users. This association was evident only among persons diagnosed with diabetes.
氟喹诺酮类抗生素与代谢不良事件有关。本研究调查了氟喹诺酮类药物与糖尿病和非糖尿病患者严重低血糖之间的因果关系。
我们使用 Optum 索赔数据进行了倾向评分匹配队列研究。我们纳入了 2000 年 1 月至 2015 年 9 月期间因特定感兴趣感染而服用口服氟喹诺酮类药物或对照抗生素的成年人。严重低血糖的定义采用验证算法。在使用感兴趣的混杂变量拟合的倾向得分上进行匹配后，使用条件逻辑回归估计糖尿病和非糖尿病队列中的比值比（OR）。
我们的队列包含 119112 名患有糖尿病的个体和 917867 名未患糖尿病的个体，他们暴露于氟喹诺酮类药物中，并与对照药物 1:1 匹配。匹配产生了所有纳入倾向评分的变量的平衡（标准化均差<0.1）。氟喹诺酮类药物与严重低血糖之间的关联在整个队列中的 OR 为 1.28（95%置信区间 [CI]：1.04-1.57），在糖尿病患者中为 1.30（95% CI：1.05-1.62），在非糖尿病患者中为 1.06（95% CI：0.53-2.13）。
与对照抗生素使用者相比，氟喹诺酮类药物使用者发生严重低血糖的风险增加。这种关联仅在诊断为糖尿病的人群中明显。
