The absolute risk of incident type 2 diabetes following exposure to systemic corticosteroids in selected steroid-related and phenotypic groups.

Autor: Ambery P; Late-stage Development, Cardiovascular, Renal and Metabolism, BioPharmaceuticals R&D, AstraZeneca, Gothenburg, Sweden., Adamsson Eryd S; BioPharmaceuticals Medical, CVRM Evidence, AstraZeneca, Gothenburg, Sweden., Jenkins-Jones S; Global Epidemiology, Pharmatelligence, Cardiff, UK., Heywood B; Global Epidemiology, Pharmatelligence, Cardiff, UK., Berni E; Global Epidemiology, Pharmatelligence, Cardiff, UK., Brown MN; Research and Early Development, Respiratory & Immunology, BioPharmaceuticals R&D, AstraZeneca, Boston, Massachusetts, USA., Astbury C; Research and Early Development, Respiratory & Immunology, BioPharmaceuticals R&D, AstraZeneca, Cambridge, UK., Hunt P; BioPharmaceuticals Medical, CVRM Evidence, AstraZeneca, Gaithersburg, Maryland, USA., Currie CJ; Global Epidemiology, Pharmatelligence, Cardiff, UK.; Division of Population Medicine, School of Medicine, Cardiff University, Cardiff, UK.
Jazyk: angličtina
Zdroj: Diabetes, obesity & metabolism [Diabetes Obes Metab] 2022 Nov; Vol. 24 (11), pp. 2222-2231. Date of Electronic Publication: 2022 Aug 04.
DOI: 10.1111/dom.14808
Abstrakt: Aims: Exposure to corticosteroids is known to increase the risk of developing type 2 diabetes. We estimated the risk of incident type 2 diabetes in selected patient groups exposed to systemic corticosteroids.
Materials and Methods: In a retrospective, observational cohort study, using real-world data from UK primary care, patients were selected who had at least one episode of exposure to oral or intravenous corticosteroids for any indication. Corticosteroid-exposed patients were matched with non-exposed patients. Relative dosage was estimated as a weight-based, prednisolone-equivalent dose. Crude rates of progression to type 2 diabetes were determined for patient groups defined by relevant steroid-related and phenotypic characteristics present at corticosteroid exposure.
Results: Overall, rates of incidence of type 2 diabetes were 12.5 and 6.7 events per thousand person-years' (pkpy) exposure, respectively, in those who received at least one dose of corticosteroids versus those never exposed. This represented a rate ratio of 1.85 (95% CI 1.74-1.97). The incidence of type 2 diabetes was found to be associated with several of the selected characteristics, both individually and multi-dimensionally. The highest rate of incident type 2 diabetes was observed in very severely obese men aged 46-55 years having had the longest corticosteroid exposure and highest corticosteroid dose (190 incident events pkpy exposure).
Conclusions: Corticosteroid exposure increased the risk of incident type 2 diabetes, and there was evidence of both a dose-response and a duration response. The impact of corticosteroid exposure upon the rate of incident type 2 diabetes appeared, however, to involve a complex, multi-dimensional interaction between the selected characteristics, some of which might be impacted by reverse causality.
(© 2022 John Wiley & Sons Ltd.)
Databáze: MEDLINE
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