Use of Statins Not Associated with an Increased Risk of Microvascular Disease用他汀类药物与微血管病变的风险增加无关

Use of statins before diagnosis of incident diabetes was not associated with an increased risk of microvascular disease, according to a national Danish study. The study identified all patients living in Denmark who were aged 40 years or older and were diagnosed with incident diabetes between Jan 1, 1996, and Dec 31, 2009. 15 679 individuals who had used statins regularly until their diagnosis of diabetes (statin users) were randomly selected and matched in a 1:3 ratio with 47 037 individuals who had never used statins before diagnosis (non-statin users). Data were analyzed with Cox regression models, adjusted for covariates including sex, age at diabetes diagnosis, and method of diabetes diagnosis as well as adjustments with a propensity score and with other factors. Median follow-up was 2•7 years (range 0—13). Compared with non-statin users, statin users had a lower cumulative incidence of diabetic retinopathy, diabetic neuropathy, and gangrene of the foot, but not diabetic nephropathy. A previous meta analysis suggested that intensive-dose statin therapy may be associated with an increased risk of new-onset diabetes compared with moderate-dose statin therapy. Source: http://www.thelancet.com/; http://jama.jamanetwork.com/根据丹麦的一项全国性研究，糖尿病确诊之前使用他汀类药物与微血管病变的风险增加无关。该研究确定了40岁或以上在丹麦生活并在1996年1月1日和2009年12月31日之间确诊为糖尿病的所有患者。随机选择了经常使用他汀类药物的15679人（他汀类药物使用者）并以1：3的比例与从未使用过他汀类药物的47037人（非他汀类药物使用者）匹配。所得资料以Cox回归模型，经校正协变量，包括性别，确诊糖尿病的年龄和方法，以及校正有倾向性评分和其他因素进行分析。中位随访时间为2•7年（范围0-13 年）。与非他汀类药物使用者相比，他汀类药物使用者糖尿病性视网膜病，糖尿病性神经病，和脚坏疽的累积发病率较低，而非糖尿病肾病发病率。先前的荟萃分析表明，与中等剂量他汀类药物治疗相比，强化剂量的他汀类药物与新发糖尿病的风险增加有关。来源：http://www.thelancet.com/; http://jama.jamanetwork.com/