| アブストラクト | AIM: The glucagon-like peptide-1 receptor agonist (GLP1a) liraglutide has been described to benefit patients with type 2 diabetes mellitus (T2DM) at high cardiovascular risk. However, there are still uncertainties relating to these cardiovascular benefits: whether they also apply to an unselected diabetic population that includes low-risk patients, represent a class-effect, and could be observed in a real-world setting. METHODS: We conducted a population-based, retrospective open cohort study using data derived from The Health Improvement Network database between Jan 2008 to Sept 2015. Patients with T2DM exposed to GLP1a (n=8345) were compared to age, gender, body mass index, duration of T2DM and smoking status-matched patients with T2DM unexposed to GLP1a (n=16,541). RESULTS: Patients with diabetes receiving GLP1a were significantly less likely to die from any cause compared to matched control patients with diabetes (adjusted incidence rate ratio [aIRR]: 0.64, 95% CI: 0.56-0.74, P-value<0.0001). Similar findings were observed in low-risk patients (aIRR: 0.64, 95% CI: 0.53-0.76, P -value=0.0001). No significant difference in the risk of incident CVD was detected in the low-risk patients (aIRR: 0.93, 95% CI: 0.83-1.12). Subgroup analyses suggested that effect is persistent in the elderly or across glycated haemoglobin categories. CONCLUSIONS: GLP1a treatment in a real-world setting may confer additional mortality benefit in patients with T2DM irrespective of their baseline CVD risk, age or baseline glycated haemoglobin and was sustained over the observation period. |
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| ジャーナル名 | Diabetes & metabolism |
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| Pubmed追加日 | 2017/3/23 |
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| 投稿者 | Toulis, K A; Hanif, W; Saravanan, P; Willis, B H; Marshall, T; Kumarendran, B; Gokhale, K; Ghosh, S; Cheng, K K; Narendran, P; Thomas, G N; Nirantharakumar, K |
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| 組織名 | Institute of Applied Health Research, University of Birmingham, Birmingham,;United Kingdom; 424 General Military Hospital, Thessaloniki, Greece.;Diabetes Department, University Hospitals Birmingham NHS Foundation Trust,;Birmingham, United Kingdom.;University of Warwick & George Eliot Hospital, Coventry, United Kingdom.;United Kingdom.;Birmingham, United Kingdom; Institute of Metabolism and Systems Research,;University of Birmingham, Birmingham, United Kingdom.;United Kingdom. Electronic address: gneilthomas@yahoo.co.uk.;United Kingdom; Diabetes Department, University Hospitals Birmingham NHS;Foundation Trust, Birmingham, United Kingdom. Electronic address:;k.nirantharan@bham.ac.uk. |
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| Pubmed リンク | https://www.ncbi.nlm.nih.gov/pubmed/28325589/ |
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