Modest effect of statins on fasting glucose in a longitudinal electronic health record based cohort.
Modest effect of statins on fasting glucose in a longitudinal electronic health record based cohort.
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他汀类药物对基于纵向电子健康记录的队列中禁食葡萄糖的适度作用。
DOI：
10.1186/s12933-022-01566-w
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发表时间：
2022-07-14
影响因子：
9.3
通讯作者：
中科院分区：
文献类型：
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作者：
先前对他汀类药物血糖影响的研究并不一致。此外，大多数研究只考虑了短期使用他汀类药物；长期使用他汀类药物对空腹血糖 (FG) 的影响尚未得到充分研究。这项工作的目的是研究长期他汀类药物暴露对 FG 水平的影响。使用来自大型且多样化的纵向队列的电子健康记录（EHR）数据，我们以两种方式定义长期他汀类药物暴露：他汀类药物使用的累积年数（累积供应量）和年份的供应加权剂量总和（累积剂量）。辛伐他汀、洛伐他汀、阿托伐他汀和普伐他汀均包含在分析中。使用混合效应模型的线性回归检查了他汀类药物暴露与 FG 之间的关系，比较了他汀类药物使用者和从不使用他汀类药物之前和之后的情况。我们在中位随访 20 年的时间里检查了 87,151 人的 593,130 次 FG 测量值。其中，42,678 名从未使用过他汀类药物，44,473 名使用过他汀类药物，总计 730,031 张他汀类药物处方。当两种措施都在同一模型中时，FG 与他汀类药物的累积供应量呈正相关，但与计算剂量无关。虽然具有统计显着性，但由于他汀类药物暴露导致的 FG 每年增加幅度不大，仅为 0.14 mg/dl，并且他汀类药物类型之间仅存在轻微且不显着的差异。 FG 水平升高与他汀类药物暴露有关，但影响不大。结果表明，对于大多数人来说，长期使用他汀类药物导致临床上 FG 显着增加的风险很小。在线版本包含可在 10.1186/s12933-022-01566-w 获取的补充材料。
Prior studies of the glycemic effect of statins have been inconsistent. Also, most studies have only considered a short duration of statin use; the effect of long-term statin use on fasting glucose (FG) has not been well examined. The aim of this work is to investigate the effect of long-term statin exposure on FG levels. Using electronic health record (EHR) data from a large and diverse longitudinal cohort, we defined long-term statin exposure in two ways: the cumulative years of statin use (cumulative supply) and the years’ supply-weighted sum of doses (cumulative dose). Simvastatin, lovastatin, atorvastatin and pravastatin were included in the analysis. The relationship between statin exposure and FG was examined using linear regression with mixed effects modeling, comparing statin users before and after initiating statins and statin never-users. We examined 593,130 FG measurements from 87,151 individuals over a median follow up of 20 years. Of these, 42,678 were never-users and 44,473 were statin users with a total of 730,031 statin prescriptions. FG was positively associated with cumulative supply of statin but not comulative dose when both measures were in the same model. While statistically significant, the annual increase in FG attributable to statin exposure was modest at only 0.14 mg/dl, with only slight and non-significant differences among statin types. Elevation in FG level is associated with statin exposure, but the effect is modest. The results suggest that the risk of a clinically significant increase in FG attributable to long-term statin use is small for most individuals. The online version contains supplementary material available at 10.1186/s12933-022-01566-w.
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影响因子：
168.9
作者：
Ridker, Paul M.;Pradhan, Aruna;MacFadyen, Jean G.;Libby, Peter;Glynn, Robert J.
通讯作者：
Glynn, Robert J.
他汀类药物治疗的患者中发生糖尿病的风险：基于人群的研究。
DOI：
10.1136/bmj.f2610
发表时间：
2013-05-23
期刊：
BMJ (Clinical research ed.)
影响因子：
--
作者：
Carter AA;Gomes T;Camacho X;Juurlink DN;Shah BR;Mamdani MM
通讯作者：
Mamdani MM
影响因子：
3.2
作者：
Ma, Tsochiang;Tien, Liyun;Jong, Gwo-Ping
通讯作者：
Jong, Gwo-Ping
影响因子：
2.6
作者：
Sukhija, Rishi;Prayaga, Sastry;Mehta, Jawahar L.
通讯作者：
Mehta, Jawahar L.
影响因子：
168.9
作者：
Sattar, Naveed;Preiss, David;Ford, Ian
通讯作者：
Ford, Ian