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An Overview of Risk Factors for Diabetic Foot Amputation: An Observational, Single-centre, Retrospective Cohort Study. 糖尿病足截肢危险因素综述:一项观察性、单中心、回顾性队列研究。
Pub Date : 2023-05-01 DOI: 10.17925/EE.2023.19.1.85
Burak Yuzuguldu, Bugra Zengin, Ilgin Yildirim Simsir, Sevki Cetinkalp

Introduction: Not only are early detection and treatment of diabetic foot ulcers important, but also acknowledging potential risk factors for amputation gives clinicians a considerable advantage in preventing amputations. Amputations impact both healthcare services and the physical and mental health of patients. This study aimed to investigate the risk factors for amputation in patients with diabetic foot ulcers.

Methods: The sample for this study was patients with diabetic foot ulcers who were treated by the diabetic foot council at our hospital between 2005 and 2020. A total of 32 risk factors for amputation were identified and investigated among 518 patients.

Results: Our univariate analysis showed that 24 of 32 defined risk factors were statistically significant. In the multivariate analysis using the Cox regression model, seven risk factors remained statistically significant. The risk factors most significantly associated with amputation were Wagner grading, abnormal peripheral arteries, hypertension, high thrombocyte levels, low haematocrit levels, hypercholesterolaemia and male sex, respectively. The most common cause of death in patients with diabetes who have undergone amputation is cardiovascular disease, followed by sepsis.

Conclusion: To enable optimum treatment of patients with diabetic foot ulcers it is important for physicians to be aware of the amputation risk factors, and thus avoid amputations. Correcting risk factors, using suitable footwear and routinely inspecting feet are crucial factors for preventing amputations in patients with diabetic foot ulcers.

导言:不仅早期发现和治疗糖尿病足溃疡很重要,而且认识到截肢的潜在危险因素使临床医生在预防截肢方面具有相当大的优势。截肢既影响医疗保健服务,也影响患者的身心健康。本研究旨在探讨糖尿病足溃疡患者截肢的危险因素。方法:本研究的样本为2005年至2020年在我院糖尿病足委员会治疗的糖尿病足溃疡患者。在518例患者中,共发现并调查了32个截肢危险因素。结果:我们的单因素分析显示,32个确定的危险因素中有24个具有统计学意义。在Cox回归模型的多变量分析中,7个危险因素仍然具有统计学意义。与截肢最显著相关的危险因素分别是瓦格纳分级、外周动脉异常、高血压、高血小板水平、低红细胞压积水平、高胆固醇血症和男性。糖尿病截肢患者最常见的死亡原因是心血管疾病,其次是败血症。结论:了解糖尿病足溃疡的危险因素,避免截肢对糖尿病足溃疡患者的治疗具有重要意义。纠正危险因素,使用合适的鞋类和定期检查足部是预防糖尿病足溃疡患者截肢的关键因素。
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引用次数: 1
Resmetirom: An Orally Administered, Smallmolecule, Liver-directed, β-selective THR Agonist for the Treatment of Non-alcoholic Fatty Liver Disease and Non-alcoholic Steatohepatitis. 雷司替龙:一种口服小分子肝定向β选择性THR激动剂,用于治疗非酒精性脂肪性肝病和非酒精性脂肪性肝炎。
Pub Date : 2023-05-01 DOI: 10.17925/EE.2023.19.1.60
Gres Karim, Meena B Bansal

Non-alcoholic fatty liver disease (NAFLD) encompasses a spectrum of fatty liver disease, including non-alcoholic fatty liver (NAFL) and its more progressive form, non-alcoholic steatohepatitis (NASH). The prevalence of NAFLD/NASH along with type 2 diabetes and obesity is rising worldwide. In those who develop NASH, unlike those with bland steatosis (NAFL), lipotoxic lipids drive hepatocyte injury, inflammation and stellate cell activation leading to progressive accumulation of collagen or fibrosis, ultimately leading to cirrhosis and increased risk of hepatocellular carcinoma. Hypothyroidism is associated with NAFLD/NASH; specifically, intrahepatic hypothyroidism drives lipotoxicty in preclinical models. Agonists of thyroid hormone receptor (THR)-β, which is primarily found in the liver, can promote lipophagy, mitochondrial biogenesis and mitophagy, stimulating increased hepatic fatty acid β-oxidation, and thereby decreasing the burden of lipotoxic lipids, while promoting low-density lipoprotein (LDL) uptake and favourable effects on lipid profiles. A number of THR-β agonists are currently being investigated for NASH. This review focuses on resmetirom, an orally administered, once-daily, small-molecule, liver-directed, ß-selective THR agonist, as it is furthest along in development. Data from completed clincal studies outlined in this review demonstrate that resmetirom is effective in reducing hepatic fat content as measured by magnetic resonance imaging-derived proton density fat fraction, reduces liver enzymes, improves non-i nvasive markers of liver fibrogenesis and decreases liver stiffness, while eliciting a favourable cardiovascular profile with a reduction in serum lipids, including LDL cholesterol. Topline phase III biopsy data showed resolution of NASH and/or fibrosis improvement after 52 weeks of treatment, with more detailed peer-reviewed findings anticipated in order to certify these findings. Longer term clinical outcomes from both MAESTRO-NASH and MAESTRO-NASH OUTCOMES will be a pivotal juncture in the drug's road towards being approved as a NASH therapeutic.

非酒精性脂肪性肝病(NAFLD)包括一系列脂肪性肝病,包括非酒精性脂肪性肝病(NAFL)及其更为进行性的非酒精性脂肪性肝炎(NASH)。NAFLD/NASH与2型糖尿病和肥胖症的患病率在全球范围内呈上升趋势。在NASH患者中,与轻度脂肪变性(NAFL)患者不同,脂毒性脂质驱动肝细胞损伤、炎症和星状细胞活化,导致胶原或纤维化的进行性积累,最终导致肝硬化和肝细胞癌的风险增加。甲状腺功能减退与NAFLD/NASH相关;具体来说,肝内甲状腺功能减退症在临床前模型中驱动脂肪中毒。甲状腺激素受体(THR)-β激动剂主要存在于肝脏中,可促进脂肪吞噬、线粒体生物发生和线粒体自噬,刺激肝脏脂肪酸β-氧化增加,从而减少脂毒性脂质的负担,同时促进低密度脂蛋白(LDL)的摄取,并对脂质谱产生有利影响。目前正在研究一些用于NASH的THR-β激动剂。本综述的重点是雷司替罗,这是一种口服、每日一次、小分子、肝定向、ß-选择性THR激动剂,因为它的开发进展最快。本综述中概述的已完成的临床研究数据表明,雷司替罗姆可有效降低肝脏脂肪含量(通过磁共振成像衍生的质子密度脂肪分数测量),降低肝酶,改善肝纤维化的无创标志物,降低肝脏硬度,同时通过降低血清脂质(包括LDL胆固醇)引起有利的心血管状况。Topline III期活检数据显示,治疗52周后,NASH和/或纤维化得到缓解,预计将有更详细的同行评议结果来证实这些发现。MAESTRO-NASH和MAESTRO-NASH预后的长期临床结果将是该药物被批准为NASH治疗药物的关键节点。
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引用次数: 4
Glucagon-like Peptide-1 Receptor Agonists for the Treatment of Type 2 Diabetes in Youth. 胰高血糖素样肽-1受体激动剂治疗青少年2型糖尿病。
Pub Date : 2023-05-01 DOI: 10.17925/EE.2023.19.1.38
Casey Berman, Alaina P Vidmar, Lily C Chao

Glucagon-like peptide-1 receptor agonists (GLP-1RAs) have gained traction for the management of type 2 diabetes and obesity. Unlike several classes of antidiabetic medications that contribute to weight gain, GLP-1RAs not only reduce haemoglobin A1c, but also promote weight loss. While there is a large body of evidence supporting its safety and efficacy in adults, paediatric clinical trial data have only emerged in recent years. This review will discuss the limited treatment options for paediatric type 2 diabetes and the mechanism of action of GLP-1RAs as it pertains to physiological pathways relevant for type 2 diabetes, obesity and their related comorbidities. The outcomes of paediatric trials evaluating liraglutide, exenatide, semaglutide and dulaglutide in paediatric type 2 diabetes and obesity will be closely examined, including differences compared with adult studies. Finally, potential barriers and strategies to expanding GLP-1RA access in adolescents will be discussed. Future studies are needed to determine if the cardio-and renal-protective benefits of GLP-1RAs apply to youth-onset type 2 diabetes.

胰高血糖素样肽-1受体激动剂(GLP-1RAs)在2型糖尿病和肥胖的治疗中获得了广泛的应用。与几种导致体重增加的抗糖尿病药物不同,GLP-1RAs不仅能降低血红蛋白A1c,还能促进体重减轻。虽然有大量证据支持其在成人中的安全性和有效性,但儿科临床试验数据仅在最近几年才出现。这篇综述将讨论小儿2型糖尿病的有限治疗方案和GLP-1RAs的作用机制,因为它涉及与2型糖尿病、肥胖及其相关合并症相关的生理途径。评估利拉鲁肽、艾塞那肽、西马鲁肽和杜拉鲁肽治疗儿童2型糖尿病和肥胖症的儿科试验的结果将被仔细研究,包括与成人研究的差异。最后,将讨论在青少年中扩大GLP-1RA获取的潜在障碍和策略。未来的研究需要确定GLP-1RAs对心脏和肾脏的保护作用是否适用于年轻发病的2型糖尿病。
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引用次数: 0
Polycystic Ovary Syndrome as Metabolic Disease: New Insights on Insulin Resistance. 多囊卵巢综合征作为代谢疾病:胰岛素抵抗的新见解。
Pub Date : 2023-05-01 DOI: 10.17925/EE.2023.19.1.71
Alessandro D Genazzani, Andrea R Genazzani

Polycystic ovary syndrome (PCOS) is a very frequent disease that affects reproductive ability and menstrual regularity. Other than the criteria established at the Rotterdam consensus, in these last few years a new issue, insulin resistance, has been found frequently, and at a very high grade, in patients with PCOS. Insulin resistance occurs for several factors, such as overweight and obesity, but it is now clear that it occurs in patients with PCOS with normal weight, thus supporting the hypothesis that insulin resistance is independent of body weight. Evidence shows that a complex pathophysiological situation occurs that impairs post-receptor insulin signalling, especially in patients with PCOS and familial diabetes. In addition, patients with PCOS have a high incidence of non-alcoholic fatty liver disease related to the hyperinsulinaemia. This narrative review focuses on the recent new insights about insulin resistance in patients with PCOS, to better understand the metabolic impairment accounting for most of the clinical signs/symptoms of PCOS.

多囊卵巢综合征(PCOS)是一种影响生殖能力和月经规律的常见病。除了在鹿特丹共识中建立的标准,在过去的几年里,一个新的问题,胰岛素抵抗,在多囊卵巢综合征患者中经常被发现,而且是非常高的级别。胰岛素抵抗的发生有多种因素,如超重和肥胖,但现在很清楚,它发生在体重正常的多囊卵巢综合征患者中,从而支持了胰岛素抵抗与体重无关的假设。有证据表明,一种复杂的病理生理状况会损害受体后胰岛素信号传导,特别是在多囊卵巢综合征和家族性糖尿病患者中。此外,多囊卵巢综合征患者与高胰岛素血症相关的非酒精性脂肪肝发病率高。本文综述了最近关于多囊卵巢综合征患者胰岛素抵抗的新见解,以更好地了解多囊卵巢综合征大部分临床体征/症状的代谢障碍。
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引用次数: 4
Epigenetics of the Pathogenesis and Complications of Type 2 Diabetes Mellitus. 2型糖尿病发病机制及并发症的表观遗传学研究。
Pub Date : 2023-05-01 DOI: 10.17925/EE.2023.19.1.46
Velmurugan Mannar, Hiya Boro, Deepika Patel, Sourabh Agstam, Mazhar Dalvi, Vikash Bundela

Epigenetics of type 2 diabetes mellitus (T2DM) has widened our knowledge of various aspects of the disease. The aim of this review is to summarize the important epigenetic changes implicated in the disease risks, pathogenesis, complications and the evolution of therapeutics in our current understanding of T2DM. Studies published in the past 15 years, from 2007 to 2022, from three primary platforms namely PubMed, Google Scholar and Science Direct were included. Studies were searched using the primary term 'type 2 diabetes and epigenetics' with additional terms such as 'risks', 'pathogenesis', 'complications of diabetes' and 'therapeutics'. Epigenetics plays an important role in the transmission of T2DM from one generation to another. Epigenetic changes are also implicated in the two basic pathogenic components of T2DM, namely insulin resistance and impaired insulin secretion. Hyperglycaemia-i nduced permanent epigenetic modifications of the expression of DNA are responsible for the phenomenon of metabolic memory. Epigenetics influences the development of micro-and macrovascular complications of T2DM. They can also be used as biomarkers in the prediction of these complications. Epigenetics has expanded our understanding of the action of existing drugs such as metformin, and has led to the development of newer targets to prevent vascular complications. Epigenetic changes are involved in almost all aspects of T2DM, from risks, pathogenesis and complications, to the development of newer therapeutic targets.

2型糖尿病(T2DM)的表观遗传学拓宽了我们对该疾病各个方面的认识。这篇综述的目的是总结在我们目前对T2DM的认识中涉及疾病风险、发病机制、并发症和治疗方法演变的重要表观遗传变化。从2007年到2022年的过去15年里,在PubMed、Google Scholar和Science Direct三个主要平台上发表的研究被纳入其中。研究使用主要术语“2型糖尿病和表观遗传学”进行搜索,附加术语如“风险”、“发病机制”、“糖尿病并发症”和“治疗方法”。表观遗传学在T2DM的代代相传中起着重要的作用。表观遗传变化也与T2DM的两个基本致病因素有关,即胰岛素抵抗和胰岛素分泌受损。高血糖诱导的DNA表达的永久表观遗传修饰是代谢记忆现象的原因。表观遗传学影响T2DM微血管和大血管并发症的发生。它们也可以作为预测这些并发症的生物标志物。表观遗传学扩大了我们对二甲双胍等现有药物作用的理解,并导致了预防血管并发症的新靶点的发展。从风险、发病机制、并发症到新治疗靶点的开发,表观遗传变化几乎涉及T2DM的所有方面。
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引用次数: 0
Emerging Evidence for the Use of Antidiabetic Drugs, Glucagon-like Peptide 1 Receptor Agonists, for the Treatment of Alzheimer's Disease. 使用降糖药物胰高血糖素样肽1受体激动剂治疗阿尔茨海默病的新证据
Pub Date : 2023-05-01 DOI: 10.17925/EE.2023.19.1.16
Ides M Colin, Lidia W Szczepanski, Anne-Catherine Gérard, Jose-Antonio Elosegi

From an epidemiological and pathophysiological point of view, Alzheimer's disease (AD) and type 2 diabetes (T2DM) should be considered 'sister' diseases. T2DM significantly increases the risk of developing AD, and the mechanisms of neuronal degeneration themselves worsen peripheral glucose metabolism in multiple ways. The pathophysiological links between the two diseases, particularly cerebral insulin resistance, which causes neuronal degeneration, are so close that AD is sometimes referred to as 'type 3 diabetes'. Although the latest news on the therapeutic front for AD is encouraging, no treatment has been shown to halt disease progression permanently. At best, the treatments slow down the progression; at worst, they are inactive, or cause worrying side effects, preventing their use on a larger scale. Therefore, it appears logical that optimizing the metabolic milieu through preventive or curative measures can also slow down the cerebral degeneration that characterizes AD. Among the different classes of hypoglycaemic drugs, glucagon-like peptide 1 receptor agonists, which are widely used in the treatment of T2DM, were shown to slow down, or even prevent, neuronal degeneration. Data from animal, preclinical, clinical phase II, cohort and large cardiovascular outcomes studies are encouraging. Of course, randomized clinical phase III studies, which are on-going, will be essential to verify this hypothesis. Thus, for once, there is hope for slowing down the neurodegenerative processes associated with diabetes, and that hope is the focus of this review.

从流行病学和病理生理学的角度来看,阿尔茨海默病(AD)和2型糖尿病(T2DM)应被视为“姐妹”疾病。T2DM显著增加AD发生的风险,且神经元退行性变本身的机制通过多种途径恶化外周糖代谢。这两种疾病之间的病理生理联系,特别是导致神经元变性的脑胰岛素抵抗,是如此紧密,以至于阿尔茨海默病有时被称为“3型糖尿病”。尽管阿尔茨海默病治疗前沿的最新消息令人鼓舞,但没有任何治疗方法被证明可以永久阻止疾病进展。治疗充其量只能减缓病情的发展;在最坏的情况下,它们是无效的,或者会引起令人担忧的副作用,从而阻止它们的大规模使用。因此,通过预防或治疗措施优化代谢环境也可以减缓AD特征的大脑变性,这似乎是合乎逻辑的。在不同类型的降糖药物中,广泛用于治疗T2DM的胰高血糖素样肽1受体激动剂(glucagon-like peptide 1 receptor agonists)被证明可以减缓甚至预防神经元变性。来自动物、临床前、临床II期、队列和大型心血管结局研究的数据令人鼓舞。当然,正在进行的随机临床III期研究将对验证这一假设至关重要。因此,这一次,有希望减缓与糖尿病相关的神经退行性过程,这一希望是本综述的重点。
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引用次数: 2
Insulin Icodec Weekly: A Basal Insulin Analogue for Type 2 Diabetes. 胰岛素Icodec周刊:2型糖尿病的基础胰岛素类似物。
Pub Date : 2023-05-01 DOI: 10.17925/EE.2023.19.1.4
Harpreet S Bajaj, Ronald M Goldenberg

Insulin icodec is a once-weekly basal insulin analogue in late-phase clinical development. Similar efficacy and safety of icodec to once-daily basal insulin analogues have been reported in over 4,200 participants with type 2 diabetes from three phase II and five phase III trials. Indeed, glycated haemoglobin reduction was superior for icodec among insulin-naïve participants (ONWARDS 1, 3 and 5) and in those switching from a daily basal insulin in ONWARDS 2, with the latter trial demonstrating improved diabetes treatment satisfaction scores with insulin icodec versus insulin degludec.

胰岛素icodec是一种处于临床晚期的每周一次的基础胰岛素类似物。在超过4200名2型糖尿病患者的3个II期和5个III期试验中,icodec的疗效和安全性与每日一次的基础胰岛素类似物相似。事实上,在insulin-naïve参与者(第一三和第一五组)和第一二组从每日基础胰岛素转换的参与者中,icodec的糖化血红蛋白降低效果更优,后者的试验显示胰岛素icodec比胰岛素degludec改善了糖尿病治疗满意度得分。
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引用次数: 1
Use of Continuous Glucose Monitoring in Older Adults: A Review of Benefits, Challenges and Future Directions. 在老年人中使用连续血糖监测:益处、挑战和未来方向的回顾。
Pub Date : 2022-11-01 DOI: 10.17925/EE.2022.18.2.116
Lalita Prasad-Reddy, Alvin Godina, Ashwin Chetty, Diana Isaacs

Many new technologies have been developed over the past decade, and these have substantially changed the way diabetes is managed. Continuous glucose monitoring is now the standard of care for many people living with diabetes, and among its numerous benefits, it has been shown to improve glycaemic outcomes and enhance quality of life. Older adults carry a high burden of diabetes and have a high risk of hypo-glycaemia and hypo-glycaemic unawareness, and continuous glucose monitoring can help to improve glycaemic management in this vulnerable population. Unfortunately, only a few trials have evaluated the effectiveness of continuous glucose monitoring in older adults. Certainly, the implementation of continuous glucose monitoring in older adults can come with many challenges, including logistical, educational and reimbursement barriers. This article will discuss the benefits of continuous glucose monitoring in older adults with diabetes, the clinical studies that support its use and the barriers to its optimal implementation in this population.

在过去的十年中已经开发了许多新技术,这些技术大大改变了糖尿病的管理方式。持续血糖监测现在是许多糖尿病患者的标准护理,它有许多好处,已被证明可以改善血糖结果和提高生活质量。老年人糖尿病负担高,低血糖和低血糖不自觉的风险高,持续的血糖监测可以帮助改善这一脆弱人群的血糖管理。不幸的是,只有少数试验评估了老年人持续血糖监测的有效性。当然,在老年人中实施持续血糖监测可能会遇到许多挑战,包括后勤、教育和报销障碍。本文将讨论连续血糖监测对老年糖尿病患者的益处,支持其使用的临床研究以及在该人群中最佳实施的障碍。
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引用次数: 1
Testosterone Replacement Therapy: A Narrative Review with a Focus on New Oral Formulations. 睾酮替代疗法:以新的口服制剂为重点的叙述性回顾。
Pub Date : 2022-11-01 DOI: 10.17925/EE.2022.18.2.133
Salman Z Bhat, Adrian S Dobs

Male hypogonadism affects 10-30% of the male population and is often under-recognized and under-treated. Different replacement formulations exist, each with specific benefits and limitations. These replacements include gels, patches and short- and long-acting injectables. JATENZO® (oral testosterone undecanoate; Clarus Therapeutics Inc., Northbrook, IL, US) is the first oral formulation of testosterone approved by the US Food and Drug Administration. TLANDO® (oral testosterone undecanoate; Lipocine Inc., Salt Lake City, UT, US), another oral testosterone formulation, has also recently been approved by the US Food and Drug Administration. Based on unique chemistry using a self-emulsifying drug delivery system and lymphatic absorption, JATENZO and TLANDO address some of the limitations of other dosing routes while providing a safe option without evidence of liver dysfunction. This review discusses various testosterone treatment options, focusing on the role and pharmacokinetics of the new oral formulations.

男性性腺功能减退影响10-30%的男性人口,但往往未得到充分认识和治疗。存在不同的替代配方,每种配方都有特定的优点和局限性。这些替代品包括凝胶、贴片和短效和长效注射剂。JATENZO®(口服十一酸睾酮;Clarus Therapeutics Inc., Northbrook, IL, US)是第一个获得美国食品和药物管理局批准的口服睾酮制剂。TLANDO®(口服十一酸睾酮;Lipocine Inc., Salt Lake City, UT, US)是另一种口服睾酮制剂,最近也获得了美国食品和药物管理局的批准。JATENZO和TLANDO基于独特的化学成分,利用自乳化药物输送系统和淋巴吸收,解决了其他给药途径的一些局限性,同时提供了一种安全的选择,没有肝功能障碍的证据。这篇综述讨论了各种睾酮治疗方案,重点是新的口服制剂的作用和药代动力学。
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引用次数: 1
Assessing the Incidence of New-onset Diabetes Mellitus with Statin Use: A Systematic Review of the Systematic Reviews and Meta-analyses. 评估新发糖尿病与他汀类药物的发病率:系统综述和荟萃分析的系统综述。
Pub Date : 2022-11-01 DOI: 10.17925/EE.2022.18.2.96
Harmanjit Singh, Pallavi Sikarwar, Supreet Khurana, Jatin Sharma

Statin use has been linked with new-onset diabetes mellitus (NODM). In the present systematic review, we aimed to determine the incidence of NODM with statin use by assessing and summarizing the data generated by different systematic reviews and metaanalyses published on this topic. We conducted a systematic review of systematic reviews and meta-analyses using a pre-defined study protocol. Two authors independently performed a literature search using PubMed, Embase and the Cochrane Central Register of Controlled Trials (CENTRAL) for studies reporting data on statin use and NODM incidence and screened and extracted data for the outcomes of interest. The Assessing the Methodological Auality of Systematic Reviews 2 (AMSTAR 2) checklist was used to evaluate the quality of the included systematic reviews and meta-analyses. The initial search yielded 621 potential records, and 16 relevant systematic reviews and meta-analyses were included in the present systematic review. The included studies showed an increase in the risk of NODM with statin use. In particular, rosuvastatin and atorvastatin were associated with NODM in many systematic reviews or meta-analyses; however, pravastatin and pitavastatin were found to be associated with lower or no risk. We observed a positive trend of development of NODM with statin use became more evident with advancing years as more number of studies were added. Intensive doses of statins and use in older subjects were found to be important risk factors for NODM. Finally, the quality assessment revealed that the included systematic reviews and metaanalyses were of critically low or low quality. We concluded that statin use carries a risk of causing NODM. Statins should not be discouraged in anticipation of NODM. However, glycaemic monitoring should be encouraged with the on-going statin therapy. Furthermore, clinical studies addressing the use of statins and the incidence of NODM as their primary objective should be planned.

他汀类药物与新发糖尿病(NODM)有关。在本系统综述中,我们旨在通过评估和总结发表在该主题上的不同系统综述和荟萃分析产生的数据,确定他汀类药物使用NODM的发生率。我们使用预先定义的研究方案对系统评价和荟萃分析进行了系统评价。两位作者分别使用PubMed、Embase和Cochrane中央对照试验登记册(Central Register of Controlled Trials, Central)对报告他汀类药物使用和NODM发病率数据的研究进行文献检索,并筛选和提取感兴趣的结果数据。评估系统评价的方法学质量2 (AMSTAR 2)检查表用于评估纳入的系统评价和荟萃分析的质量。最初的检索产生了621条潜在记录,本系统评价纳入了16项相关的系统评价和荟萃分析。纳入的研究表明,使用他汀类药物会增加NODM的风险。特别是,在许多系统评价或荟萃分析中,瑞舒伐他汀和阿托伐他汀与NODM相关;然而,普伐他汀和匹伐他汀被发现与较低或无风险相关。我们观察到,随着研究数量的增加,NODM与他汀类药物使用的积极发展趋势变得越来越明显。大剂量的他汀类药物和老年受试者的使用被发现是NODM的重要危险因素。最后,质量评估显示,纳入的系统评价和荟萃分析质量极低或低。我们的结论是他汀类药物有引起NODM的风险。他汀类药物不应因预期NODM而停用。然而,血糖监测应鼓励进行他汀类药物治疗。此外,应计划将他汀类药物的使用和NODM的发生率作为其主要目标的临床研究。
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TouchREVIEWS in endocrinology
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