接受外周动脉血运重建的2型糖尿病患者使用噻唑烷二酮类和钠葡萄糖共转运蛋白2抑制剂的心血管结局
Cardiovascular outcomes with thiazolidinediones and sodium-glucose cotransporter 2 inhibitors in patients with type 2 diabetes mellitus undergoing peripheral artery revascularization.
摘要(中文译文)
在因2型糖尿病（T2DM）接受外周动脉血运重建的患者中，抗糖尿病药物的比较有效性仍不明确。利用韩国国民健康保险理赔数据库（2015—2023年），我们筛选出接受外周动脉血运重建（血管内或外科手术）的T2DM患者。为控制基线差异，我们采用1：3倾向性评分匹配，比较噻唑烷二酮类（TZD）与二肽基肽酶-4抑制剂（DPP-4i），以及钠-葡萄糖共转运蛋白-2抑制剂（SGLT-2i）与DPP-4i。采用分层Cox回归模型评估主要结局的风险，主要结局定义为主要不良肢体事件（再次血运重建或截肢）、卒中、心肌梗死、心力衰竭住院和全因死亡的复合终点。主要结局在TZD使用者中发生率为49.3%，而DPP-4i使用者为55.5%（HR 0.74；95% CI 0.63-0.86；p < 0.001）；在SGLT-2i使用者中为39.7%，而DPP-4i使用者为52.2%（HR 0.88；95% CI 0.79-0.98；p = 0.015）。关于次要结局，与DPP-4i使用者相比，TZD使用者与较低的主要不良肢体事件和全因死亡风险相关。SGLT-2i治疗与全因死亡减少相关。在接受外周动脉血运重建的T2DM患者中，与DPP-4i相比，TZD和SGLT-2i与更有利的临床结局相关。
Abstract
The comparative effectiveness of anti-diabetic agents in patients with type 2 diabetes mellitus (T2DM) undergoing peripheral artery revascularization remains unclear. Using the Korean National Health Insurance Claims database (2015-2023), we identified patients with T2DM who underwent peripheral artery revascularization (endovascular or surgical). To control for baseline differences, we utilized 1:3 propensity score matching to compare thiazolidinediones (TZD) vs. dipeptidyl peptidase-4 inhibitors (DPP-4i), and sodium-glucose co-transporter-2 inhibitors (SGLT-2i) vs. DPP-4i. Stratified Cox regression model assessed the risk for the primary outcome, defined as a composite of major adverse limb events (repeated revascularization or amputation), stroke, myocardial infarction, admission for heart failure, and all-cause death. The primary outcome occurred in 49.3% of TZD users versus 55.5% of DPP-4i users (HR 0.74; 95% CI 0.63-0.86; p < 0.001) and in 39.7% of SGLT-2i users versus 52.2% of DPP-4i users (HR 0.88; 95% CI 0.79-0.98; p = 0.015). Regarding secondary outcomes, TZD users were associated with lower risks of major adverse limb events, and all-cause death compared with DPP-4i users. SGLT-2i treatment was associated with reduced all-cause death. Among patients with T2DM undergoing peripheral artery revascularization, TZD and SGLT-2i were associated with favourable clinical outcomes compared to DPP-4i.
如何引用
AMA
Ji Woong Roh, Jimin Jeon, Joonsang Yoo, Minyoul Baik, Seok-Jae Heo, Deok-Kyu Cho, et al. Cardiovascular outcomes with thiazolidinediones and sodium-glucose cotransporter 2 inhibitors in patients with type 2 diabetes mellitus undergoing peripheral artery revascularization.. Diabetes research and clinical practice. 2026; doi:10.1016/j.diabres.2026.113281.
APA
Ji Woong Roh, Jimin Jeon, Joonsang Yoo, Minyoul Baik, Seok-Jae Heo, Deok-Kyu Cho, et al (2026). Cardiovascular outcomes with thiazolidinediones and sodium-glucose cotransporter 2 inhibitors in patients with type 2 diabetes mellitus undergoing peripheral artery revascularization.. Diabetes research and clinical practice. https://doi.org/10.1016/j.diabres.2026.113281
GB/T 7714
Ji Woong Roh, Jimin Jeon, Joonsang Yoo, Minyoul Baik, Seok-Jae Heo, Deok-Kyu Cho, et al. Cardiovascular outcomes with thiazolidinediones and sodium-glucose cotransporter 2 inhibitors in patients with type 2 diabetes mellitus undergoing peripheral artery revascularization.[J]. Diabetes research and clinical practice, 2026 doi:10.1016/j.diabres.2026.113281.
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