Wang Jui, Lee Szu-Ying, Chao Chia-Ter, Huang Jenq-Wen, Chien Kuo-Liong
Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan.
Health Data Research Center, National Taiwan University, Taipei, Taiwan.
NPJ Aging. 2024 Oct 7;10(1):44. doi: 10.1038/s41514-024-00173-1.
Patients with diabetes mellitus (DM) are at risk of developing frailty, but studies rarely addressed risk factors for frailty worsening. We investigated whether blood pressure (BP)-lowering agents influenced such risk in these patients. Adults with type 2 DM were identified from National Taiwan University Hospital, with the primary outcome, the worsening of frailty by ≧1 score increase of FRAIL scale determined. We used the Cox proportional hazards analysis to derive the risk of worsening frailty associated with BP-lowering agents. Among 41,440 patients with DM, 27.4% developed worsening frailty after 4.09 years of follow-up. Cox regression revealed that diuretics (hazard ratio (HR) 1.12, 95% confidence interval (CI) 1.06-1.18) and α-blocker (HR 1.14, 95% CI 1.06-1.23) users had a significantly higher risk of worsening frailty than non-users, whereas the risk was lower among β-blocker users (HR 0.93, 95% CI 0.88-0.98). It would be therefore prudent to weigh the advantages and disadvantages of using specific BP-lowering agent classes.
糖尿病（DM）患者有发生衰弱的风险，但很少有研究探讨衰弱恶化的危险因素。我们调查了降压药物是否会影响这些患者的此类风险。从台湾大学医院识别出2型糖尿病成年人，主要结局为根据衰弱量表（FRAIL）评分增加≧1分判定的衰弱恶化。我们使用Cox比例风险分析来得出与降压药物相关的衰弱恶化风险。在41440例糖尿病患者中，27.4%在4.09年的随访后出现衰弱恶化。Cox回归显示，使用利尿剂（风险比（HR）1.12，95%置信区间（CI）1.06 - 1.18）和α受体阻滞剂（HR 1.14，95% CI 1.06 - 1.23）的患者衰弱恶化风险显著高于未使用者，而β受体阻滞剂使用者的风险较低（HR 0.93，95% CI 0.88 - 0.98）。因此，权衡使用特定类别降压药物的利弊是谨慎的做法。
