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【文摘发布】口服降血糖疗法对退伍军人卫生管
DOI: 10.2337/dc06-2272
TITLE: Impact of oral anti-hyperglycemic therapy on all-cause mortality among patients with diabetes in the Veterans Health Administration
Kristijan H. Kahler, PhD, Mangala Rajan, MBA, George G. Rhoads, MD, Monika M. Safford, MD, Kitaw Demissie, PhD, Shou-En Lu, PhD and Leonard M. Pogach, MD
ABSTRACT
Objective:The objective of this analysis was to evaluate the impact of several classes of oral anti-hyperglycemic therapy relative to sulfonylurea monotherapy on all-cause mortality among a cohort of patients with diabetes from the Veterans Health Administration (VHA).
Research Design and Methods:A retrospective cohort study using data obtained from the VHA Diabetes Epidemiology Cohort was employed. Users of oral anti-hyperglycemic therapy were classified into the following cohorts: sulfonylurea monotherapy, metformin monotherapy, metformin + sulfonylurea, TZD use alone or in combination with other oral agents (TZD users), and no drug therapy. All-cause mortality was the outcome of interest. Multivariate mixed models incorporating a propensity score to account for imbalance among cohorts were used to estimate drug effects on mortality with associated 95% confidence intervals (95%CI).
Results:39,721 patients with diabetes were included in the study. Adjusted odds ratios and 95%CIs for all-cause mortality were 0.87 (0.68, 1.10) for metformin monotherapy users, 0.92 (0.82, 1.05) for metformin + sulfonylurea users, 1.04 (0.75, 1.46) for TZD users, relative to sulfonylurea monotherapy users.
Conclusions:We did not find any significant drug effect on all-cause mortality for any oral treatment cohorts relative to sulfonylurea oral-monotherapy. RESOURCE ：Diabetes Care Publish Ahead of Print published online ahead of print April 17, 2007
消息来源：《糖尿病护理》在印刷版出版前提前网络发表，2007年4月17日
DOI: 10.2337/dc06-2272
TITLE: Impact of oral anti-hyperglycemic therapy on all-cause mortality among patients with diabetes in the Veterans Health Administration
口服降血糖疗法对退伍军人卫生管理局中糖尿病患者全因死亡率的影响
Kristijan H. Kahler, PhD, Mangala Rajan, MBA, George G. Rhoads, MD, Monika M. Safford, MD, Kitaw Demissie, PhD, Shou-En Lu, PhD and Leonard M. Pogach, MD
ABSTRACT
摘要
Objective:The objective of this analysis was to evaluate the impact of several classes of oral anti-hyperglycemic therapy relative to sulfonylurea monotherapy on all-cause mortality among a cohort of patients with diabetes from the Veterans Health Administration (VHA).
目的：这项分析的目的在于评估多类口服降血糖疗法，相对于单用磺酰脲类治疗，对退伍军人卫生管理局(VHA)中一群糖尿病患者的全因死亡率的影响。
Research Design and Methods:A retrospective cohort study using data obtained from the VHA Diabetes Epidemiology Cohort was employed. Users of oral anti-hyperglycemic therapy were classified into the following cohorts: sulfonylurea monotherapy, metformin monotherapy, metformin + sulfonylurea, TZD use alone or in combination with other oral agents (TZD users), and no drug therapy. All-cause mortality was the outcome of interest. Multivariate mixed models incorporating a propensity score to account for imbalance among cohorts were used to estimate drug effects on mortality with associated 95% confidence intervals (95%CI).
研究设计和方法：采用VHA糖尿病流行病学队列进行一项回顾性队列研究。口服降血糖患者分成以下队列：磺酰脲类单一治疗者，二甲双胍单一治疗者，磺酰脲类加用二甲双胍治疗者，仅使用吡格列酮或联合其它口服制剂（TZD使用者），未进行药物治疗者等。全因死亡率是本研究关注的结果。运用多变量混合摸型，加上说明不同队列间不均衡性的倾向评分，使用95%可信区间估计药物作用对死亡率的影响。
Results:39,721 patients with diabetes were included in the study. Adjusted odds ratios and 95%CIs for all-cause mortality were 0.87 (0.68, 1.10) for metformin monotherapy users, 0.92 (0.82, 1.05) for metformin + sulfonylurea users, 1.04 (0.75, 1.46) for TZD users, relative to sulfonylurea monotherapy users.
结果：本研究共采纳39,721位糖尿病患者。二甲双胍单一治疗队列，磺酰脲类加用二甲双胍队列，吡格列酮使用队列分别与磺酰脲类单一治疗队列对比，全因死亡率的调整后优势比和95%可信区间分别为0.87(0.68,1.10), 0.92 (0.82, 1.05) 和1.04 (0.75, 1.46)
Conclusions:We did not find any significant drug effect on all-cause mortality for any oral treatment cohorts relative to sulfonylurea oral-monotherapy.
结论：相对于磺酰脲类单一口服治疗，我们在其它所有口服治疗队列中没有发现药物作用对全因死亡率有任何显著影响
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作者:admin@医学,生命科学 2011-02-28 05:11
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