口服降糖药还能降低糖尿病患者新冠感染相关死亡风险？看看哪些药在红名单上吧！

2022-12-28 liangying MedSci原创发表于上海

二甲双胍、DPP4i、SGLT2i和GLP1RA治疗极有可能降低糖尿病患者的COVID-19死亡风险，而胰岛素可能与死亡风险增加有关。磺酰脲类药物和TZDs治疗与死亡率无关。

新冠感染的流行呈持续快速发展形势，对糖尿病患者构成了挑战。先前的研究表明，糖尿病是新冠肺炎患者预后和死亡的独立风险因素。新冠肺炎合并糖尿病患者住院率高，对其预后有不良影响，大多数新冠肺炎死亡发生在糖尿病患者中。在众多的糖尿病治疗方案中，有必要为患有新冠肺炎的糖尿病患者制定一个相对有利的治疗方案。

抗糖尿病药物已被证明具有降糖、抗炎和免疫调节作用。为了确定降糖药对患有新冠肺炎糖尿病患者临床结局的影响，已经进行了大量研究。此外，一些配对荟萃分析研究了特定抗糖尿病药物对新冠肺炎死亡率和严重不良预后的作用，包括二甲双胍、二肽基肽酶4抑制剂（DPP4i）、磺酰脲、胰岛素和胰高血糖素样肽1受体激动剂（GLP1RA）。然而，这些调查只是将服用特定抗糖尿病药物的患者与正常人群的结果进行了比较，这些患者中不同抗糖尿病药物之间的死亡率风险尚不清楚。

本研究旨在评估不同抗糖尿病药物与新冠感染死亡风险之间的关系，以及糖尿病患者严重疾病结局的风险。

研究者检索了PubMed、Web of Science、Embase和Cochrane图书馆数据库，从成立到2021年10月31日，包括7种抗糖尿病药物。数据通过传统的两两元分析和贝叶斯网络元分析汇集。

成对荟萃分析包括35项研究。结果发现，二甲双胍、DPP4i、钠-葡萄糖协同转运蛋白-2抑制剂（SGLT2i）和胰高血糖素样肽-1受体激动剂（GLP1RA）治疗极有可能降低糖尿病患者的COVID-19死亡风险，而胰岛素可能与死亡风险增加有关。磺酰脲类药物和噻唑烷二酮（TZDs）治疗与死亡率无关。所研究的抗糖尿病药物均与严重疾病的风险无关。此外，GLP1RA可能对死亡有最显著的保护作用，其次是SGLT2i和二甲双胍。

参考文献：Chen Y, Lv X, Lin S, Arshad M, Dai M. The Association Between Antidiabetic Agents and Clinical Outcomes of COVID-19 Patients With Diabetes: A Bayesian Network Meta-Analysis. Front Endocrinol (Lausanne). 2022 May 27;13:895458. doi: 10.3389/fendo.2022.895458. PMID: 35692410; PMCID: PMC9186017.

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2022-12-28 nurseba 来自广东省

感谢分享！

56 0
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2022-12-28 delianjihui 来自新疆

有无可能是重症才用胰岛素，所以预后本身就差呢

66 0
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2022-12-28 delianjihui 来自新疆

客观评价

47 0
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2022-12-28 delianjihui 来自新疆

感谢分享

49 0
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2022-12-28 delianjihui 来自新疆

转发学习

50 0
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2022-12-28 delianjihui 来自新疆

学习受益

34 0

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口服降糖药还能降低糖尿病患者新冠感染相关死亡风险？看看哪些药在红名单上吧！

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