Cargando…

A Randomized Trial of Low-Dose Aspirin in the Prevention of Clinical Type 2 Diabetes in Women

OBJECTIVE—Subclinical inflammation is linked with the development of type 2 diabetes, and epidemiologic data suggest that this association may be stronger in women. Although small clinical studies have shown a prominent hypoglycemic effect of short-term high-dose aspirin, no randomized trials have d...

Descripción completa

Detalles Bibliográficos
Autores principales: Pradhan, Aruna D., Cook, Nancy R., Manson, JoAnn E., Ridker, Paul M., Buring, Julie E.
Formato: Texto
Lenguaje:English
Publicado: American Diabetes Association 2009
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2606820/
https://www.ncbi.nlm.nih.gov/pubmed/18835953
http://dx.doi.org/10.2337/dc08-1206
_version_ 1782162988713639936
author Pradhan, Aruna D.
Cook, Nancy R.
Manson, JoAnn E.
Ridker, Paul M.
Buring, Julie E.
author_facet Pradhan, Aruna D.
Cook, Nancy R.
Manson, JoAnn E.
Ridker, Paul M.
Buring, Julie E.
author_sort Pradhan, Aruna D.
collection PubMed
description OBJECTIVE—Subclinical inflammation is linked with the development of type 2 diabetes, and epidemiologic data suggest that this association may be stronger in women. Although small clinical studies have shown a prominent hypoglycemic effect of short-term high-dose aspirin, no randomized trials have directly evaluated the efficacy of aspirin in diabetes prevention at doses acceptable for use in routine clinical practice. We evaluated whether chronic low-dose aspirin prevents the development of clinical diabetes among initially healthy American women. RESEARCH DESIGN AND METHODS—Subjects were enrolled in the Women's Health Study, a 10-year randomized double-blind, placebo-controlled trial of aspirin and vitamin E for primary prevention of cardiovascular disease and cancer. Between 1992 and 1995, 38,716 women aged ≥45 years and free of clinical diabetes were randomly assigned to either low-dose aspirin or placebo (median follow-up 10.2 years). Documented clinical type 2 diabetes was prospectively evaluated throughout the trial. RESULTS—Among women randomly assigned to receive aspirin (n = 19,326) or placebo (n = 19,390), there was no statistically significant difference in the incidence of type 2 diabetes. There were 849 cases of diabetes in the aspirin group and 847 in the placebo group (rate ratio 1.01 [95% CI 0.91–1.11]). Stratification by diabetes risk factors including age, BMI, family history of diabetes, physical activity, A1C, and high-sensitivity C-reactive protein did not support a modulating effect of these variables. Analyses accounting for treatment duration and adherence similarly found no beneficial effects. CONCLUSIONS—These data suggest that long-term low-dose aspirin does not prevent the development of clinical type 2 diabetes in initially healthy women.
format Text
id pubmed-2606820
institution National Center for Biotechnology Information
language English
publishDate 2009
publisher American Diabetes Association
record_format MEDLINE/PubMed
spelling pubmed-26068202010-01-01 A Randomized Trial of Low-Dose Aspirin in the Prevention of Clinical Type 2 Diabetes in Women Pradhan, Aruna D. Cook, Nancy R. Manson, JoAnn E. Ridker, Paul M. Buring, Julie E. Diabetes Care Clinical Care/Education/Nutrition/Psychosocial Research OBJECTIVE—Subclinical inflammation is linked with the development of type 2 diabetes, and epidemiologic data suggest that this association may be stronger in women. Although small clinical studies have shown a prominent hypoglycemic effect of short-term high-dose aspirin, no randomized trials have directly evaluated the efficacy of aspirin in diabetes prevention at doses acceptable for use in routine clinical practice. We evaluated whether chronic low-dose aspirin prevents the development of clinical diabetes among initially healthy American women. RESEARCH DESIGN AND METHODS—Subjects were enrolled in the Women's Health Study, a 10-year randomized double-blind, placebo-controlled trial of aspirin and vitamin E for primary prevention of cardiovascular disease and cancer. Between 1992 and 1995, 38,716 women aged ≥45 years and free of clinical diabetes were randomly assigned to either low-dose aspirin or placebo (median follow-up 10.2 years). Documented clinical type 2 diabetes was prospectively evaluated throughout the trial. RESULTS—Among women randomly assigned to receive aspirin (n = 19,326) or placebo (n = 19,390), there was no statistically significant difference in the incidence of type 2 diabetes. There were 849 cases of diabetes in the aspirin group and 847 in the placebo group (rate ratio 1.01 [95% CI 0.91–1.11]). Stratification by diabetes risk factors including age, BMI, family history of diabetes, physical activity, A1C, and high-sensitivity C-reactive protein did not support a modulating effect of these variables. Analyses accounting for treatment duration and adherence similarly found no beneficial effects. CONCLUSIONS—These data suggest that long-term low-dose aspirin does not prevent the development of clinical type 2 diabetes in initially healthy women. American Diabetes Association 2009-01 /pmc/articles/PMC2606820/ /pubmed/18835953 http://dx.doi.org/10.2337/dc08-1206 Text en Copyright © 2009, American Diabetes Association https://creativecommons.org/licenses/by-nc-nd/3.0/Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered. See http://creativecommons.org/licenses/by-nc-nd/3.0/ for details.
spellingShingle Clinical Care/Education/Nutrition/Psychosocial Research
Pradhan, Aruna D.
Cook, Nancy R.
Manson, JoAnn E.
Ridker, Paul M.
Buring, Julie E.
A Randomized Trial of Low-Dose Aspirin in the Prevention of Clinical Type 2 Diabetes in Women
title A Randomized Trial of Low-Dose Aspirin in the Prevention of Clinical Type 2 Diabetes in Women
title_full A Randomized Trial of Low-Dose Aspirin in the Prevention of Clinical Type 2 Diabetes in Women
title_fullStr A Randomized Trial of Low-Dose Aspirin in the Prevention of Clinical Type 2 Diabetes in Women
title_full_unstemmed A Randomized Trial of Low-Dose Aspirin in the Prevention of Clinical Type 2 Diabetes in Women
title_short A Randomized Trial of Low-Dose Aspirin in the Prevention of Clinical Type 2 Diabetes in Women
title_sort randomized trial of low-dose aspirin in the prevention of clinical type 2 diabetes in women
topic Clinical Care/Education/Nutrition/Psychosocial Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2606820/
https://www.ncbi.nlm.nih.gov/pubmed/18835953
http://dx.doi.org/10.2337/dc08-1206
work_keys_str_mv AT pradhanarunad arandomizedtrialoflowdoseaspirininthepreventionofclinicaltype2diabetesinwomen
AT cooknancyr arandomizedtrialoflowdoseaspirininthepreventionofclinicaltype2diabetesinwomen
AT mansonjoanne arandomizedtrialoflowdoseaspirininthepreventionofclinicaltype2diabetesinwomen
AT ridkerpaulm arandomizedtrialoflowdoseaspirininthepreventionofclinicaltype2diabetesinwomen
AT buringjuliee arandomizedtrialoflowdoseaspirininthepreventionofclinicaltype2diabetesinwomen
AT pradhanarunad randomizedtrialoflowdoseaspirininthepreventionofclinicaltype2diabetesinwomen
AT cooknancyr randomizedtrialoflowdoseaspirininthepreventionofclinicaltype2diabetesinwomen
AT mansonjoanne randomizedtrialoflowdoseaspirininthepreventionofclinicaltype2diabetesinwomen
AT ridkerpaulm randomizedtrialoflowdoseaspirininthepreventionofclinicaltype2diabetesinwomen
AT buringjuliee randomizedtrialoflowdoseaspirininthepreventionofclinicaltype2diabetesinwomen