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慢性肝病患者循证抗糖尿病药物的选择与警示

Selection and Warning of Evidence-Based Antidiabetic Medications for Patients With Chronic Liver Disease.

作者信息

Yen Fu-Shun, Hsu Chih-Cheng, Wei James Cheng-Chung, Hou Ming-Chih, Hwu Chii-Min

机构信息

Dr. Yen's Clinic, Taoyuan, Taiwan.

Institute of Population Health Sciences, National Health Research Institute, Miaoli, Taiwan.

出版信息

Front Med (Lausanne). 2022 Feb 16;9:839456. doi: 10.3389/fmed.2022.839456. eCollection 2022.

DOI:10.3389/fmed.2022.839456
PMID:35252271
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8888965/
Abstract

The global prevalence of chronic liver disease and diabetes mellitus (DM) has gradually increased potentially due to changes in diet and lifestyle. The choice of antidiabetic medications for patients with coexisting DM and chronic liver disease is complicated. Severe liver injury may decrease the metabolism of antidiabetic medications, resulting in elevated drug concentrations and adverse effects. The choice of antidiabetic medications in patients with chronic liver disease has not been well studied. The long-term outcomes of antidiabetic medications in patients with chronic liver disease have gained attention recently. Herein, we reviewed relevant articles to extend our understanding on the selection and warning of antidiabetic medications for patients with chronic liver disease.

摘要

由于饮食和生活方式的改变,全球慢性肝病和糖尿病(DM)的患病率逐渐上升。对于同时患有糖尿病和慢性肝病的患者,抗糖尿病药物的选择很复杂。严重肝损伤可能会降低抗糖尿病药物的代谢,导致药物浓度升高和不良反应。慢性肝病患者抗糖尿病药物的选择尚未得到充分研究。抗糖尿病药物在慢性肝病患者中的长期疗效最近受到了关注。在此,我们回顾了相关文章,以加深我们对慢性肝病患者抗糖尿病药物选择和警示的理解。

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Selection and Warning of Evidence-Based Antidiabetic Medications for Patients With Chronic Liver Disease.慢性肝病患者循证抗糖尿病药物的选择与警示
Front Med (Lausanne). 2022 Feb 16;9:839456. doi: 10.3389/fmed.2022.839456. eCollection 2022.
2
Variation in antidiabetic medication intensity among Medicare beneficiaries with diabetes mellitus.患有糖尿病的医疗保险受益人群中抗糖尿病药物治疗强度的差异。
Am J Geriatr Pharmacother. 2007 Sep;5(3):195-208. doi: 10.1016/j.amjopharm.2007.10.004.
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Oral antidiabetic agents: current role in type 2 diabetes mellitus.口服抗糖尿病药物:在2型糖尿病中的当前作用
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Impact of diabetes mellitus on risk of cardiovascular disease and all-cause mortality: Evidence on health outcomes and antidiabetic treatment in United States adults.糖尿病对心血管疾病风险和全因死亡率的影响:美国成年人健康结局及抗糖尿病治疗的证据
World J Diabetes. 2016 Oct 15;7(18):449-461. doi: 10.4239/wjd.v7.i18.449.
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Antidiabetic Drugs in NAFLD: The Accomplishment of Two Goals at Once?用于非酒精性脂肪性肝病的抗糖尿病药物:能否一举实现两个目标?
Pharmaceuticals (Basel). 2018 Nov 8;11(4):121. doi: 10.3390/ph11040121.
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Use of antidiabetic medications and risk of chronic obstructive pulmonary disease exacerbation requiring hospitalization: a disease risk score-matched nested case-control study.使用抗糖尿病药物与需要住院治疗的慢性阻塞性肺疾病恶化风险:疾病风险评分匹配的巢式病例对照研究。
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Dipeptidyl peptidase-4 inhibitors may accelerate cirrhosis decompensation in patients with diabetes and liver cirrhosis: a nationwide population-based cohort study in Taiwan.二肽基肽酶-4 抑制剂可能会加速糖尿病合并肝硬化患者的肝硬化失代偿:一项来自中国台湾的全国基于人群的队列研究。
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Use of multiple antidiabetic medications in patients with diabetes and its association with hypoglycaemic events: a case-crossover study in Jordan.在患有糖尿病的患者中使用多种抗糖尿病药物及其与低血糖事件的关系:在约旦的病例交叉研究。
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Innovative Drugs First Implemented in Type 2 Diabetes Mellitus and Obesity and Their Effects on Metabolic Dysfunction-Associated Steatohepatitis (MASH)-Related Fibrosis and Cirrhosis.创新药物在2型糖尿病和肥胖症中的首次应用及其对代谢功能障碍相关脂肪性肝炎(MASH)相关纤维化和肝硬化的影响。
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本文引用的文献

1
Metformin use and cirrhotic decompensation in patients with type 2 diabetes and liver cirrhosis.二甲双胍在 2 型糖尿病合并肝硬化患者中的应用与肝硬化失代偿。
Br J Clin Pharmacol. 2022 Jan;88(1):311-322. doi: 10.1111/bcp.14970. Epub 2021 Jul 22.
2
Is insulin the preferred treatment in persons with type 2 diabetes and liver cirrhosis?对于 2 型糖尿病合并肝硬化的患者,胰岛素是首选治疗药物吗?
BMC Gastroenterol. 2021 Jun 12;21(1):263. doi: 10.1186/s12876-021-01773-x.
3
Dipeptidyl peptidase-4 inhibitors may accelerate cirrhosis decompensation in patients with diabetes and liver cirrhosis: a nationwide population-based cohort study in Taiwan.
Hypoglycemic agents and bone health; an umbrella systematic review of the clinical trials' meta-analysis studies.
降糖药与骨骼健康:临床试验荟萃分析研究的伞状系统评价
Diabetol Metab Syndr. 2024 Dec 23;16(1):310. doi: 10.1186/s13098-024-01518-2.
4
Dapagliflozin as an oral antihyperglycemic agent in the management of diabetes mellitus in patients with liver cirrhosis.达格列净作为口服降糖药用于肝硬化患者糖尿病的管理。
World J Exp Med. 2024 Dec 20;14(4):95272. doi: 10.5493/wjem.v14.i4.95272.
5
Impact of GLP-1RA on the Risk of Adverse Liver Outcomes Among Patients With Alcohol-Associated Liver Disease and Type 2 Diabetes.胰高血糖素样肽-1受体激动剂对酒精性肝病合并2型糖尿病患者不良肝脏结局风险的影响
Liver Int. 2025 Apr;45(4):e16132. doi: 10.1111/liv.16132. Epub 2024 Oct 15.
6
From liver to hormones: The endocrine consequences of cirrhosis.从肝脏到激素:肝硬化的内分泌后果。
World J Gastroenterol. 2024 Mar 7;30(9):1073-1095. doi: 10.3748/wjg.v30.i9.1073.
7
Association of Dipeptidyl Peptidase-4 Inhibitors Use with Reduced Risk of Hepatocellular Carcinoma in Type 2 Diabetes Patients with Chronic HBV Infection.二肽基肽酶-4抑制剂的使用与慢性乙型肝炎病毒感染的2型糖尿病患者肝细胞癌风险降低的关联
Cancers (Basel). 2023 Feb 10;15(4):1148. doi: 10.3390/cancers15041148.
二肽基肽酶-4 抑制剂可能会加速糖尿病合并肝硬化患者的肝硬化失代偿:一项来自中国台湾的全国基于人群的队列研究。
Hepatol Int. 2021 Feb;15(1):179-190. doi: 10.1007/s12072-020-10122-1. Epub 2021 Jan 10.
4
Sulfonylureas may be useful for glycemic management in patients with diabetes and liver cirrhosis.磺酰脲类药物可能对伴有肝硬化的糖尿病患者的血糖控制有用。
PLoS One. 2020 Dec 14;15(12):e0243783. doi: 10.1371/journal.pone.0243783. eCollection 2020.
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Effects of SGLT2 inhibitors on eGFR in type 2 diabetic patients-the role of antidiabetic and antihypertensive medications.SGLT2 抑制剂对 2 型糖尿病患者 eGFR 的影响——降糖和降压药物的作用。
Hypertens Res. 2021 May;44(5):508-517. doi: 10.1038/s41440-020-00590-1. Epub 2020 Dec 14.
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15. Diabetes Care in the Hospital: .医院中的糖尿病护理: 。
Diabetes Care. 2021 Jan;44(Suppl 1):S211-S220. doi: 10.2337/dc21-S015.
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A Placebo-Controlled Trial of Subcutaneous Semaglutide in Nonalcoholic Steatohepatitis.一项安慰剂对照试验评估皮下司美格鲁肽在非酒精性脂肪性肝炎中的疗效。
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Thiazolidinediones were associated with higher risk of cardiovascular events in patients with type 2 diabetes and cirrhosis.噻唑烷二酮类药物与2型糖尿病合并肝硬化患者发生心血管事件的较高风险相关。
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Hepatology. 2020 Nov;72(5):1880-1882. doi: 10.1002/hep.31270.