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首页> 外文期刊>Anaesthesia and intensive care >Effect of statins on insulin requirements during non-cardiac surgery.
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Effect of statins on insulin requirements during non-cardiac surgery.

机译：他汀类药物对非心脏手术中胰岛素需求的影响。

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Statins are thought to potentially impair glucose metabolism, increasing plasma glucose concentration. The effect of prolonged statin use on glucose metabolism among outpatients is thus well established. However, the impact of statin use on glucose concentrations and insulin requirements during surgery remains poorly characterised and may very well differ considering the substantial hyperglycaemic stress response to surgery. We conducted a study to test the hypothesis that patients taking statins preoperatively require more intraoperative insulin than non-users. We analysed 173 adults having major non-cardiac surgery who participated in the Dexamethasone, Light Anaesthesia and Tight Glucose Control Trial between 2007 and 2010. We compared statin and non-statin users on total amount of intraoperative insulin to maintain plasma glucose concentration within 4.4 to 6.1 mmol/l using the inverse propensity score weighting method. Sixty-seven patients were statin users and 106 were non-statin users. The estimated ratio of geometric means between the statin users and the non-users was 1.45 (95% confidence interval: 0.93, 2.26, statin versus non-statin, P=0.11). The total amount of intraoperative insulin usage did not differ significantly among patients taking different types of statins (P=0.50). While the total amount of intraoperative insulin used was not statistically different between the statin users and non-users, we observed a potentially important trend toward insulin resistance intraoperatively among statin users during major non-cardiac surgery. This result is consistent with non-operative settings and cardiac surgery. Further investigation is essential to determine whether this effect is real and, if so, determine which specific statins are more associated with insulin resistance.
机译：他汀类药物被认为可能损害葡萄糖代谢，增加血浆葡萄糖浓度。因此，长期使用他汀类药物对门诊病人葡萄糖代谢的影响已得到充分证实。然而，他汀类药物的使用对手术过程中葡萄糖浓度和胰岛素需求的影响仍然不明确，考虑到对手术的实质性高血糖应激反应，可能存在很大差异。我们进行了一项研究，以检验以下假设：术前服用他汀类药物的患者术中胰岛素比非使用者更多。我们分析了2007年至2010年间参加地塞米松，轻度麻醉和严格葡萄糖对照试验的173名接受非心脏大手术的成年人。我们比较了他汀类和非他汀类药物使用者术中胰岛素的总量，以将血糖浓度维持在4.4至使用倾向性得分加权方法测得6.1 mmol / l。他汀类药物使用者67例，非他汀类药物使用者106例。他汀类药物使用者和非他汀类药物之间的几何平均值估计比率为1.45（95％置信区间：0.93、2.26，他汀类药物与非他汀类药物比较，P = 0.11）。服用不同类型他汀类药物的患者术中使用胰岛素的总量没有显着差异（P = 0.50）。尽管他汀类药物使用者和非他汀类药物使用的术中胰岛素总量没有统计学差异，但我们观察到在非心脏大手术期间他汀类药物使用者术中胰岛素抵抗的潜在重要趋势。该结果与非手术设置和心脏手术一致。进一步研究对于确定这种作用是否是真实的是必不可少的，如果是这样，则确定哪些特定他汀类药物与胰岛素抵抗更为相关。

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