钠-葡萄糖共转运蛋白 2 抑制剂与住院患者糖尿病酮症酸中毒风险的相关性：一项多中心队列研究。
Association of sodium glucose co-transporter-2 inhibitors with risk of diabetic ketoacidosis among hospitalized patients: A multicentre cohort study.
机构信息
Institute of Health Policy, Management and Evaluation, University of Toronto, Ontario, Canada; Division of Endocrinology, Diabetes and Metabolism, Beth Israel Deaconess Medical Center, Boston, MA, United States of America.
Division of General Internal Medicine, Sinai Health System, Toronto, Ontario, Canada.
出版信息
J Diabetes Complications. 2024 Sep;38(9):108827. doi: 10.1016/j.jdiacomp.2024.108827. Epub 2024 Jul 29.
INTRODUCTION
Sodium glucose co-transporter-2 inhibitors (SGLT-2i) are increasingly being used among hospitalized patients. Our objective was to assess the risk of diabetic ketoacidosis (DKA) among hospitalized patients receiving an SGLT-2i.
RESEARCH DESIGN AND METHODS
We conducted a multicentre cohort study of patients hospitalized at 19 hospitals. We included patients over 18 years of age who received an SGLT-2i or a dipeptidyl peptidase-4 inhibitor (DPP-4i) in hospital. The primary outcome was the risk of DKA during their hospitalization.
RESULTS
61,517 patients received a DPP-4i and 11,061 received an SGLT-2i. The risk of inpatient DKA was 0.07 % (N = 41 events) among adults who received a DPP-4i and 0.18 % (N = 20 events) among adults who received an SGLT-2i; adjusted odds ratio of 3.30 (95 % CI: 1.85-5.72).
CONCLUSIONS
In hospitalized patients, the absolute risk of DKA was 0.2 %, which corresponded to a three-fold higher relative risk.
简介
钠-葡萄糖共转运蛋白 2 抑制剂（SGLT-2i）在住院患者中的应用越来越广泛。我们的目的是评估住院患者使用 SGLT-2i 后发生糖尿病酮症酸中毒（DKA）的风险。
研究设计和方法
我们进行了一项多中心队列研究，纳入了 19 家医院的住院患者。我们纳入了年龄大于 18 岁、在住院期间使用 SGLT-2i 或二肽基肽酶-4 抑制剂（DPP-4i）的患者。主要结局是住院期间发生 DKA 的风险。
结果
61517 例患者使用了 DPP-4i，11061 例患者使用了 SGLT-2i。使用 DPP-4i 的成年人中，住院期间 DKA 的风险为 0.07%（N=41 例事件），使用 SGLT-2i 的成年人中，该风险为 0.18%（N=20 例事件）；调整后的比值比为 3.30（95%CI：1.85-5.72）。
结论
在住院患者中，DKA 的绝对风险为 0.2%，对应的相对风险增加了三倍。
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