Department of Family Medicine and Medical Research, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chiayi, Taiwan.
China Medical University, Taichung, Taiwan.
Sci Rep. 2022 Jun 2;12(1):9195. doi: 10.1038/s41598-022-13133-0.
This study aimed to determine the effect of colchicine use on the risk of stroke among patients with diabetes mellitus (DM). We retrospectively enrolled patients with DM between 2000 and 2013 from the Longitudinal Health Insurance Database and divided them into a colchicine cohort (n = 8761) and noncolchicine cohort (n = 8761) by using propensity score matching (PSM). The event of interest was a stroke, including ischemic stroke and hemorrhagic stroke. The incidence of stroke was analyzed using multivariate Cox proportional hazards models between the colchicine cohort and the comparison cohort after adjustment for several confounding factors. The subdistribution hazard model was also performed for examination of the competing risk. The colchicine cohort had a significantly lower incidence of stroke [adjusted hazard ratios (aHR), 95% confidence intervals (95%CI)] (aHR = 0.61, 95%CI = 0.55-0.67), ischemic stroke (aHR = 0.59, 95%CI = 0.53-0.66), and hemorrhagic stroke (aHR = 0.66, 95%CI = 0.53-0.82) compared with the noncolchicine cohort. Drug analysis indicated that patients in the colchicine cohort who received colchicine of cumulative daily defined dose (cDDD) > 14 and duration > 28 days had a lower risk of stroke and ischemic stroke compared with nonusers. The colchicine cohort (cDDD > 150, duration > 360 days) also had a lower risk of stroke, ischemic stroke, and hemorrhagic stroke. The cumulative incidence of stroke, ischemic stroke, and hemorrhagic stroke in the colchicine cohort was significantly lower than that in the noncolchicine cohort (log-rank P < 0.001). However, the subdistribution hazard model reveal the colchicine was not associated with the hemorrhagic stroke in DM patients without gout (aHR = 0.69, 95%CI = 0.47-1.00). Colchicine use with cDDD > 14 and duration > 28 days was associated with lower risk of stroke and ischemic stroke, and colchicine use with cDDD > 150 and duration > 360 days played an auxiliary role in the prevention of stroke, ischemic stroke, and hemorrhagic stroke in patients with DM. The colchicine for the hemorrhagic stroke in DM patients without gout seem to be null effect.
这项研究旨在确定秋水仙碱的使用对糖尿病患者中风风险的影响。我们回顾性地纳入了 2000 年至 2013 年间来自纵向健康保险数据库的糖尿病患者，并通过倾向评分匹配（PSM）将他们分为秋水仙碱队列（n=8761）和非秋水仙碱队列（n=8761）。感兴趣的事件是中风，包括缺血性中风和出血性中风。在调整了几个混杂因素后，使用多变量 Cox 比例风险模型分析了秋水仙碱队列和比较队列之间的中风发生率。还进行了亚分布风险模型检查竞争风险。与非秋水仙碱队列相比，秋水仙碱队列的中风发生率显著降低[校正后的危险比（aHR），95%置信区间（95%CI）]（aHR=0.61，95%CI=0.55-0.67）、缺血性中风（aHR=0.59，95%CI=0.53-0.66）和出血性中风（aHR=0.66，95%CI=0.53-0.82）。药物分析表明，秋水仙碱队列中累积日定义剂量（cDDD）>14 且持续时间>28 天的患者中风和缺血性中风的风险较低，与未使用者相比。秋水仙碱队列（cDDD>150，持续时间>360 天）也降低了中风、缺血性中风和出血性中风的风险。秋水仙碱队列的中风、缺血性中风和出血性中风的累积发生率明显低于非秋水仙碱队列（对数秩 P<0.001）。然而，亚分布风险模型显示，对于没有痛风的糖尿病患者，秋水仙碱与出血性中风无关（aHR=0.69，95%CI=0.47-1.00）。累积秋水仙碱剂量>14 且持续时间>28 天与较低的中风和缺血性中风风险相关，而累积秋水仙碱剂量>150 且持续时间>360 天在预防糖尿病患者的中风、缺血性中风和出血性中风方面发挥辅助作用。对于没有痛风的糖尿病患者的出血性中风，秋水仙碱似乎没有效果。
