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他汀类药物治疗对老年 2 型糖尿病患者死亡率的影响:一项回顾性队列研究。

Effect of statin treatment on mortality in elderly patients with type 2 diabetes mellitus patients: a retrospective cohort study.

机构信息

Division of Clinical Epidemiology, Geriatric Hospital of Nanjing Medical University, Nanjing, China.

Clinical Trial Center, Geriatric Hospital of Nanjing Medical University, Nanjing, China.

出版信息

BMC Geriatr. 2023 Sep 11;23(1):549. doi: 10.1186/s12877-023-04252-y.

Abstract

BACKGROUND

The effects of statins on the reduction of mortality in individuals aged 75 years or older remain controversial. We conducted this study to investigate whether there is an association between statin therapy and mortality in patients with type 2 diabetes mellitus (T2DM) who are over the age of 75 years.

METHODS

The present study used data from the Staged Diabetes Targeting Management Study, which began in 2005. A total of 518 T2DM patients older than 75 years were included. Cox regression analyses were used to evaluate the association between statins and specific causes of death in patients with T2DM.

RESULTS

After a follow-up period of 6.09 years (interquartile range 3.94-8.81 years), 111 out of 518 patients died. The results of Cox regression analyses showed that there was no significant association between statin use and all-cause mortality (HR 0.75; 95% CI 0.47, 1.19) after adjustment for all potential confounders. Subgroup analysis indicated that statins had no association with the risk of all-cause mortality or deaths caused by ischemic cardiovascular diseases in T2DM patients with or without coronary heart disease.

CONCLUSIONS

Our study found no significant association between all-cause mortality and statin use in T2DM patients over the age of 75 years. More evidence is needed to support the use of statins in the elderly T2DM patients.

摘要

背景

他汀类药物对 75 岁及以上人群死亡率降低的影响仍存在争议。我们进行这项研究旨在调查在 75 岁以上的 2 型糖尿病(T2DM)患者中,他汀类药物治疗与死亡率之间是否存在关联。

方法

本研究使用了 2005 年开始的分级糖尿病靶向管理研究的数据。共纳入 518 名年龄大于 75 岁的 T2DM 患者。采用 Cox 回归分析评估他汀类药物与 T2DM 患者特定死因之间的关系。

结果

在 6.09 年(四分位距 3.94-8.81 年)的随访后,518 名患者中有 111 名死亡。Cox 回归分析结果表明,在调整所有潜在混杂因素后,他汀类药物的使用与全因死亡率之间无显著关联(HR 0.75;95% CI 0.47, 1.19)。亚组分析表明,在有或无冠心病的 T2DM 患者中,他汀类药物与全因死亡率或缺血性心血管疾病导致的死亡率无关。

结论

我们的研究未发现 75 岁以上 T2DM 患者的全因死亡率与他汀类药物使用之间存在显著关联。需要更多的证据来支持在老年 T2DM 患者中使用他汀类药物。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/829d/10494359/0508dc79e0a7/12877_2023_4252_Fig1_HTML.jpg

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