目的:一项药物流行病学研究,以评估糖尿病人群中的VTE危险因素。
方法:该研究包括299,590名个体。我们观察了3450例VTE,并使用嵌套病例对照方法将其与15,875例对照进行了匹配,并收集了合并症和处方数据。通过多变量条件逻辑回归,我们用95CI计算合并症和药物的OR,以评估其与VTE的关联.
结果:糖尿病(aOR2.16;95CI1.99-2.34),炎症性肠病(1.84;1.27-2.66),和严重精神疾病(1.72;1.43-2.05)在非癌症合并症中的关联最强.胰腺(12.32;7.11-21.36),胃(8.57;4.07-18.03),肺和支气管(6.26;4.16-9.43),和卵巢癌(6.72;2.95-15.10)被列为VTE的高风险。皮质类固醇,gabapentinoids,精神药物,利塞膦酸,普拉克索与VTE的相关性最强(aOR超过1.5)。胰岛素(3.86;3.33-4.47)和磺脲类药物(2.62;2.18-3.16)的相关性强于二甲双胍(1.65;1.49-1.83)。他汀类药物和乐卡地平(0.78;0.62-0.98)与VTE风险降低相关。
结论:在这个队列中,糖尿病患病率为50%,胰腺,胃,肺和支气管,卵巢癌与VTE密切相关。皮质类固醇,gabapentinoids,精神药物与VTE的相关性最强。这对于生成用于进一步研究的假设可能是有价值的。乐卡地平可能是一种新型的抗VTE保护药物。
OBJECTIVE: A pharmacoepidemiological study to assess VTE risk factors in a diabetes-rich population.
METHODS: The study comprised 299,590 individuals. We observed 3450 VTEs and matched them with 15,875 controls using a nested case-control approach and collected data on comorbidities and prescriptions. By multivariable conditional logistic regression, we calculated ORs with 95%CIs for comorbidities and medications to evaluate their associations with VTE.
RESULTS: Diabetes (aOR 2.16; 95%CI 1.99-2.34), inflammatory bowel disease (1.84; 1.27-2.66), and severe psychiatric disorders (1.72; 1.43-2.05) had the strongest associations among the non-cancer comorbidities. Pancreatic (12.32; 7.11-21.36), stomach (8.57; 4.07-18.03), lung and bronchus (6.26; 4.16-9.43), and ovarian (6.72; 2.95-15.10) cancers were ranked as high-risk for VTE. Corticosteroids, gabapentinoids, psychotropic drugs, risedronic acid, and pramipexole were most strongly associated (aOR exceeding 1.5) with VTE. Insulin (3.86; 3.33-4.47) and sulphonylureas (2.62; 2.18-3.16) had stronger associations than metformin (1.65; 1.49-1.83). Statins and lercanidipine (0.78; 0.62-0.98) were associated with a lowered risk of VTE.
CONCLUSIONS: In this cohort, with 50% diabetes prevalence, pancreatic, stomach, lung and bronchus, and ovarian cancers were strongly associated with VTE. Corticosteroids, gabapentinoids, and psychotropic medications had the strongest associations with VTE among medications. This may be valuable for generating hypotheses for the further research. Lercanidipine may be a novel protective medication against VTE.