RT期刊文章SR电子T1协会长期抗癫痫药物的使用和事件的2型糖尿病摩根富林明神经病学神经学乔FD Lippincott Williams &威尔金斯10.1212 SP / WNL。半岛投注体育官网0000000000207222 10.1212 / WNL。0000000000207222 A1 Wei-En强尼曾A1 Chun-Wei Chang A1 Jawl-Shan黄A1 Po-Chuan Ko A1 Chun-Jing刘A1 Siew-Na Lim年2023 UL //www.ebmtp.com/content/ea半岛投注体育官网rly/2023/03/24/WNL.0000000000207222.abstract AB背景和ObjectivesDiabetes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。从长庚MethodsWe分析数据研究数据库。≥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non-enzyme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(人力资源)计算3、4、6和9年后索引日期和后续的结束。ResultsA total of 5,103 patients were analyzed, of whom 474 took non-enzyme 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 3rd 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.DiscussionThe 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 anti-seizure medications were associated with an increased risk of developing diabetes mellitus compared with non-enzyme interaction anti-seizure medications.

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