Lin Ming-Hsun, Wu Wen-Tung, Chen Yong-Chen, Lu Chieh-Hua, Su Sheng-Chiang, Kuo Feng-Chih, Chou Yu-Ching, Sun Chien-An
Division of Endocrinology and Metabolism, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei 114, Taiwan.
Department of Pharmacy, Tri-Service General Hospital, National Defense Medical Center, Taipei 114, Taiwan.
J Clin Med. 2022 Jun 2;11(11):3186. doi: 10.3390/jcm11113186.
Although the link between non-steroidal anti-inflammatory drugs (NSAIDs) and tramadol and symptomatic hypoglycemia has been documented, there is a limited understanding of the associations of NSAIDs and tramadol with the risk of type 2 diabetes mellitus (T2DM). This study was established to evaluate the association between the clinical use of NSAIDs and the risk of T2DM.
A historical cohort study was conducted using the National Health Insurance Research Database in Taiwan dated from 2000 to 2013. Patients who received NSAIDs for at least 3 prescription orders and without co-treatment of tramadol in the exposure period (from 2000 to 2005) were considered as the exposed cohort (n = 3047). In comparison, patients who received tramadol for at least 3 prescription orders and without concomitant use of NSAIDs in the exposure period were considered as the comparison cohort (n = 9141). The primary outcome was the occurrence of T2DM. Multivariable hazard ratios (HRs) with 95% confidence intervals (CIs) derived from the Cox proportional hazard models were applied to determine the association between NSAIDs use and the risk of T2DM.
In the average follow-up period of 9.56 years, there were 159 newly diagnosed T2DM, with an incidence rate of 56.96 per 10,000 person years in the exposed cohort. Comparatively, there were 1737 incident T2DM cases, with an incidence rate of 161.23 per 10,000 person years in the comparison cohort. Compared to the comparison cohort, the NSAIDs cohort showed a significantly reduced risk of T2DM with an adjusted HR of 0.31 (95% CI, 0.26-0.36).
Our cohort study provides longitudinal evidence that the use of NSAIDs was associated with a reduced risk of T2DM.
尽管非甾体抗炎药（NSAIDs）和曲马多与症状性低血糖之间的关联已有文献记载，但对于NSAIDs和曲马多与2型糖尿病（T2DM）风险的关联了解有限。本研究旨在评估NSAIDs的临床使用与T2DM风险之间的关联。
利用台湾地区2000年至2013年的国民健康保险研究数据库进行了一项历史性队列研究。在暴露期（2000年至2005年）接受至少3次NSAIDs处方且未联合使用曲马多的患者被视为暴露队列（n = 3047）。相比之下，在暴露期接受至少3次曲马多处方且未同时使用NSAIDs的患者被视为对照队列（n = 9141）。主要结局是T2DM的发生。应用Cox比例风险模型得出的多变量风险比（HRs）及95%置信区间（CIs）来确定NSAIDs使用与T2DM风险之间的关联。
在平均9.56年的随访期内，暴露队列中有159例新诊断的T2DM，发病率为每10000人年56.96例。相比之下，对照队列中有1737例T2DM病例，发病率为每10000人年161.23例。与对照队列相比，NSAIDs队列的T2DM风险显著降低，调整后的HR为0.31（95%CI，0.26 - 0.36）。
我们的队列研究提供了纵向证据，表明NSAIDs的使用与T2DM风险降低有关。
