60岁后长期使用抗生素或增加全因及心血管死亡风险
创作:szx 审核:szx 2020年01月02日
  • 纳入37516名60岁以上、无心血管疾病及癌症的女性,记录受试者在40-59岁期间及60岁后的抗生素使用情况;
  • 在约10年随访期间,共发生4536例死亡,包括728例心血管相关死亡及1206例癌症相关死亡;
  • 校正多重因素后,与未使用抗生素的女性相比,60岁后使用抗生素超过2个月的女性的全因死亡率及心血管疾病死亡率风险,分别显著升高16%和49%,但癌症死亡风险无显著变化;
  • 上述关联在40-59岁期间使用过抗生素的女性中更为显著。
主编推荐语
szx
Circulation Research上发表的一项前瞻性队列研究结果,对近4万名女性进行多年随访后,发现在60岁以后,使用抗生素2个月以上,与全因死亡及心血管疾病死亡风险增加显著相关。
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延伸阅读本研究的原文信息和链接出处,以及相关解读和评论文章。欢迎读者朋友们推荐!
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Duration and Life-Stage of Antibiotic Use and Risks of All-Cause and Cause-Specific Mortality: A Prospective Cohort Study

抗生素使用持续时间及生命阶段与全因死亡率及病因特异性死亡率:一项前瞻性队列研究

10.1161/CIRCRESAHA.119.315279

2019-12-17, Article

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Rationale: The overuse of antibiotics has been an important clinical issue, and antibiotic exposure is linked to alterations in gut microbiota, which has been related to risks of various chronic diseases such as cardiovascular disease (CVD) and cancer. Also, duration of antibiotic exposure may be a risk factor of premature death.
Objective: We investigated associations of life-stage and duration of antibiotic use during adulthood with risks of all-cause and cause-specific mortality.
Methods and Results: This prospective cohort study included 37,516 women aged {greater than or equal to}60 y who were free of CVD or cancer from the Nurses' Health Study. Participants reported a total amount of time they used antibiotics (none, <15 days, 15 days to <2 months, or {greater than or equal to}2 months) in the middle- (age 40-59) and late adulthood (age 60 or older). We estimated hazard ratios (HRs) for all-cause mortality and deaths from CVD or cancer over 10 years according to duration of antibiotic use. During 355,918 person-years of follow-up, we documented 4536 deaths from any cause (including 728 cardiovascular deaths and 1206 cancer deaths). As compared to women who did not use antibiotics, those who used them for {greater than or equal to}2 months in late adulthood had increased risks of all-cause mortality (HR 1.16; 95% CI: 1.01, 1.33) and cardiovascular mortality (HR 1.49; [95% CI: 1.04, 2.13]), but not cancer mortality (HR 0.85 [0.65, 1.12]) after adjustment for chronic metabolic diseases, antibiotic use during middle adulthood, indication for use, demographic factors, and lifestyle/dietary factors. The association was more evident among women who also used antibiotics in middle-adulthood than among those who did not use during this life-stage.
Conclusions: Long-term use of antibiotics in late adulthood may be a risk factor for all-cause and cardiovascular mortality. The unfavorable effect of antibiotic exposure for subsequent risks of deaths due to chronic diseases needs to be considered.

First Authors:
Yoriko Heianza

Correspondence Authors:
Lu Qi

All Authors:
Yoriko Heianza,Wenjie Ma,Xiang Li,Yin Cao,Andrew T Chan,Eric B Rimm,Frank B Hu,Kathryn M Rexrode,JoAnn E Manson,Lu Qi

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Circulation期刊

Use of Antibiotics and Mortality in Women Does Duration of Exposure Matter?

2020-01-30

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