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他汀类药物治疗对糖尿病发病率的影响：对一级预防的启示。

Impact of Statin Therapy on Diabetes Incidence: Implications for Primary Prevention.

作者信息

Rikhi Rishi, Shapiro Michael D

机构信息

Center for Prevention of Cardiovascular Disease, Section on Cardiovascular Medicine, Department of Internal Medicine, Wake Forest University School of Medicine, Winston-Salem, NC, 27157, USA.

出版信息

Curr Cardiol Rep. 2024 Dec;26(12):1447-1452. doi: 10.1007/s11886-024-02141-3. Epub 2024 Sep 20.

DOI:10.1007/s11886-024-02141-3
PMID:39302589
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11668843/
Abstract

PURPOSE OF REVIEW

The present review aims to summarize current evidence, explore underlying mechanisms, and help guide clinicians regarding statin therapy and diabetes risk in primary prevention.

RECENT FINDINGS

The observational and genetic epidemiology, as well as evidence from randomized controlled trials and meta-analyses, illustrate a modest, dose-dependent increase in risk of diabetes from statin therapy. Risk of new onset diabetes from statins appears to be greatest in those near the diagnostic threshold for diabetes or with diabetes risk factors prior to statin initiation. The risk of incident diabetes is vastly offset by the cardiovascular protection offered from statin therapy and should not deter guideline recommended statin initiation in primary prevention.

摘要

综述目的

本综述旨在总结当前证据，探究潜在机制，并帮助指导临床医生在一级预防中使用他汀类药物治疗及糖尿病风险方面的问题。

最新发现

观察性和遗传流行病学研究，以及随机对照试验和荟萃分析的证据表明，他汀类药物治疗会使糖尿病风险出现适度的剂量依赖性增加。他汀类药物引发新发糖尿病的风险在那些接近糖尿病诊断阈值或在开始使用他汀类药物之前就有糖尿病风险因素的人群中似乎最高。他汀类药物治疗带来的心血管保护作用大大抵消了发生糖尿病的风险，不应妨碍在一级预防中按照指南推荐开始使用他汀类药物。