Liver and Pancreatobiliary Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran.
Digestive Disease Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran.
Arch Iran Med. 2024 Oct 1;27(10):538-544. doi: 10.34172/aim.31839.
While cardiovascular disease (CVD) polypills have demonstrated significant benefits in preventing CVD events by managing CVD risk factors and improving patient adherence, their effects on blood glucose levels, an important risk factor for CVD, remain unknown.
We analyzed data from the PolyIran-Liver trial, which involved 1,508 participants aged 50 and above. Of these, 787 were randomly assigned to receive a polypill (consisting of aspirin, atorvastatin, hydrochlorothiazide, and valsartan), while 721 received usual care as the control group over a five-year period. The aim was to determine whether there were any significant differences in fasting blood sugar (FBS) levels between the two groups at baseline, middle, and end of the study. The data analysis focused on three subgroups: participants with diabetes, those with metabolic syndrome (MetS) but without diabetes, and participants without diabetes or MetS.
Of the total studied population, with a mean age of 59±6.7 years, 328(22%) were identified with diabetes, 371 (25%) with MetS but without diabetes, and 809 (54%) without diabetes or MetS. We observed a trend of rising FBS levels until month 30, followed by a subsequent decline at month 60. Participants in the polypill group exhibited lower FBS levels than the control group at both time points, with statistically significant differences in all three subgroups at month 30 and in the MetS-without diabetes at month 60 (mean difference: -9.3 mg/dl, 95% CI: 13.9 to -4.6).
The polypill used in this study may have the potential to delay the onset of diabetes in patients with MetS more effectively than in the general population. However, its beneficial effects on the blood sugar levels of diabetic individuals require further investigation.
尽管心血管疾病（CVD）复方药在通过控制心血管疾病风险因素和提高患者依从性来预防 CVD 事件方面表现出显著的益处，但它们对血糖水平（CVD 的一个重要风险因素）的影响尚不清楚。
我们分析了 PolyIran-Liver 试验的数据，该试验涉及 1508 名年龄在 50 岁及以上的参与者。其中，787 人被随机分配接受复方药（包含阿司匹林、阿托伐他汀、氢氯噻嗪和缬沙坦）治疗，而 721 人作为对照组接受常规治疗，为期 5 年。目的是确定两组在研究开始、中期和结束时空腹血糖（FBS）水平是否存在显著差异。数据分析集中在三个亚组：患有糖尿病的参与者、患有代谢综合征（MetS）但无糖尿病的参与者和无糖尿病或 MetS 的参与者。
在研究的总人群中，平均年龄为 59±6.7 岁，328（22%）人患有糖尿病，371（25%）人患有 MetS 但无糖尿病，809（54%）人无糖尿病或 MetS。我们观察到 FBS 水平在 30 个月时呈上升趋势，随后在 60 个月时下降。与对照组相比，复方药组的 FBS 水平在两个时间点均较低，在所有三个亚组中，在 30 个月时和在 MetS 无糖尿病组中在 60 个月时均具有统计学显著差异（平均差异：-9.3mg/dl，95%CI：13.9 至-4.6）。
与对照组相比，本研究中使用的复方药可能更有效地延迟 MetS 患者发生糖尿病的时间，但它对糖尿病患者血糖水平的有益影响需要进一步研究。
