TY -的T1 -协会长期抗癫痫药物的使用和事件的2型糖尿病JF -神经学乔-神经病学SP - e2071 LP - e2082做- 10.1212 / WNL。首页0000000000207222六世- 100 - 20 AU - Wei-En强尼曾盟Chun-Wei Chang盟Jawl-Shan黄盟Po-Chuan Ko AU - Chun-Jing刘盟Siew-Na Lim Y1 - 2023/05/16 UR - //www.ez-admanager.com/content/100/20/e2071.abstract首页 N2 -背景和目标糖尿病(DM)很大程度上有助于代谢综合征和心血管事件,而且它可能是癫痫的发病率。本研究的目的是调查是否长期使用抗癫痫药物(ASM)与2型糖尿病的风险。方法分析数据从长庚研究数据库。≥45岁的患者接受了ASM治疗从2001年1月至2019年5月被确定。DM-associated疾病患者和短期ASM使用被排除在外。患者分为nonenzyme交互、enzyme-inducing enzyme-inhibiting,混合ASM组。与个人相关的事件的糖尿病ASM进一步分析。倾向分数进行加权平衡差异。分析进行Cox比例回归模型和稳定逆概率加权(IPTW)治疗。风险比率(小时)计算,3,4,6,9年后索引日期和后续的结束。Results A total of 5,103 patients were analyzed, of whom 474 took nonenzyme interaction ASMs, 1,156 took enzyme-inducing ASMs, 336 took enzyme-inhibiting ASMs, and 3,137 took mixed ASMs. During follow-up (39,248 person-years), 663 patients developed new-onset DM, and the prevalence was 13.0%. The incidence of DM plateaued at 6–9 years after ASM initiation. Enzyme-inhibiting ASMs were significantly associated with a higher HR starting at the third year and then throughout the study period. The HRs were 1.93 (95% CI 1.33–2.80), 1.85 (95% CI 1.24–2.75), and 2.08 (95% CI 1.43–3.03) in unadjusted, adjusted, and stabilized IPTW models, respectively, at the end of follow-up. The dosing of ASM did not increase the risk of DM, and none of the individual ASM analyses reached statistical significance.Discussion The long-term use of enzyme-inhibiting ASMs was associated with an increased risk of incident DM, and the risk increased with the duration of treatment. These findings may guide the choice of drugs in those requiring long-term ASM therapy, particularly in high-risk individuals.Classification of Evidence This study provides Class IV evidence that enzyme-inhibiting ASMs were associated with an increased risk of developing DM compared with nonenzyme interaction ASMs.ASM=antiseizure medication; ASMD=absolute standardized mean difference; CGMH=Chang Gung Memorial Hospital; CGRD=Chang Gung Research Database; CYP=cytochrome P450; DDD=defined daily dose; DM=diabetes mellitus; GABA=γ-aminobutyric acid; HR=hazard ratio; ICD-9-CM=International Classification of Diseases, Ninth Revision, Clinical Modification; ICD-10-CM=International Classification of Diseases, Tenth Revision, Clinical Modification; IPTW=inverse probability of treatment weighting; WHO=World Health Organization ER -