Tác động của thuốc Đái Tháo Đường tới gan

Tác động của thuốc Đái Tháo Đường tới gan Featured

Nghiên cứu quốc tế cho thấy, đối với bệnh xơ gan tiến triển do bệnh gan thoái hóa mỡ không do rượu (nonalcoholic fatty liver disease - NAFLD), những bệnh nhân đái tháo đường typ 2 có kết quả tốt hơn khi sử dụng metformin so với bệnh nhân sử dụng sulfonylureas đơn trị liệu.

Bác sỹ Eduardo Vilar-Gomez, Đại học Y khoa Indiana (Hoa Kỳ) tại Hội nghị khoa học về gan 2017 đã nói với Tạp chí Medscape Medical News: “Những bệnh nhân sử dụng metformin có thể thấy lợi ích lâu dài. Với metformin, tin lượng đươch cải thiện và nguy cơ bị bệnh gan mất bù và ung thư tế bào gan giảm. Trong khi đó, sử dụng sulfornylurea có thể tăng bệnh lý gan mất bù, đặc biệt ở những bệnh nhân đơn trị liệu bằng sulfornylurea. Do vậy, các bác sỹ lâm sàng nên cố gắng xác định những bệnh nhân có tỷ lệ cao mất bù và nên ngừng chỉ định sulfornylurea.”

Bác sỹ Vilar-Gomez và các cộng sự tại Australia, Cu Ba, Hồng Kông và Tây Ban Nha đã tiến hành nghiên cứu trên 458 bệnh nhân có tiền sử được xác định NAFLD.

Nghiên cứu thuần tập bao gồm 305 người ĐTĐ typ 2 và 153 người không mắc bệnh. Trong thời gian theo dõi 5,7 năm, có 216  biến cố: 84 người chết hoặc cấy ghép mô, 90 trường hợp đầu tiên bệnh gan mất bù và 42 trường hợp ung thư tế bào gan. Chỉ có 6 trường hợp tử vong không liên quan đến bệnh gan.

Tin lượng sống ở bệnh nhân ĐTĐ kém hơn người không bị ĐTĐ là 36% so với 72%, tương tự bệnh gan mất bù là 36% so với 12%, ung thư gan là 16% so với 6% (p<0,1).

Đối với bệnh nhân ĐTĐ, việc sử dụng metformin kết hợp với giảm nguy cơ tử vong hoặc ghép tạng, bệnh gan mất bù và ung thư gan. Ngược lại, sử dụng sulfornylurea kết hợp với tăng nguy cơ tử vong hoặc ghép tạng, bệnh gan mất bù.

Kết quả nghiên cứu cho bệnh ĐTĐ là một yếu tố nguy cơ độc lập đối với sự tiến triển những sự kiện không mong muốn, bao gồm xơ gan và tử vong cũng như tác động của các thuốc điều trị đái tháo đường. Các nhà nghiên cứu mong muốn cần có những thử nghiệm lâm sàng để chứng minh tác động của các thuốc điều trị ĐTĐ đối với các tác động liên quan đến gan.

                      Dịch tóm tắt theo: Damian McNamara; Medcape, October 26, 2017

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