首页|二肽基肽酶4抑制剂对2型糖尿病患者肌酐水平影响的Meta分析

二肽基肽酶4抑制剂对2型糖尿病患者肌酐水平影响的Meta分析

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[目的]探讨二肽基肽酶4抑制剂(DPP-4i)对2型糖尿病(T2DM)患者血清肌酐(Cr)的影响.[方法]系统检索 PubMed、Embase、Cochrane Library 和 Web of Science 数据库,纳入 DPP-4i 治疗 T2DM 患者调节 Cr 的随机对照试验(RCT).采用固定效应或随机效应模型进行数据拟合,采用I2指数定量评价异质性,使用标准方法进行敏感性分析和发表偏倚检验.[结果]经系统检索数据库,纳入12项RCT,共计2 276名受试者.由于潜在异质性的原因,故采用随机效应模型进行数据拟合,DPP-4i治疗可轻度提高T2DM患者的Cr水平(WMD:0.15 mg/L,95%CI:0.03~0.27,I2=18%,P=0.02),结果具有统计学差异.根据敏感性测试,Meta分析其结果较为可靠.同时进行Begg's与Egger's检验,未见发表偏倚.[结论]T2DM患者应用DPP-4i进行降糖治疗,可能会出现血Cr水平轻度升高.未来还需开展更大样本量的多中心研究,以进一步探讨DPP-4i治疗引起Cr水平改变的临床意义.
Meta-analysis of the effect of dipeptidyl peptidase-4 inhibitor on creatinine level in type 2 diabetes patients
Aim To investigate the effect of dipeptidyl peptidase-4 inhibitor(DPP-4i)on serum creatinine(Cr)in patients with type 2 diabetes mellitus(T2DM).Methods A systematic search was performed across data-bases of PubMed,Embase,Cochrane Library and Web of Science,and randomized controlled trials(RCT)of DPP-4i therapy for regulating Cr in T2DM patients was included.A fixed-effect or random-effect model was used for data fitting,heterogeneity was quantitatively evaluated according to the index of I2,and sensitivity analysis and publication bias testing were performed by using the standard methods.Results After searching the database through the system,12 RCTs were included,with a total of 2 276 participants.Due to the potential heterogeneity,a random effect model was used for data fitting.DPP-4i treatment could mildly increase Cr levels in T2DM patients(WMD:0.15 mg/L,95%CI:0.03~0.27,I=1 8%,P=0.02),and the results showed statistical differences.According to sensitivity testing,the results of Meta-analysis were relatively reliable.No publication bias was observed according to Begg's and Egger's tests.Conclusions The use of DPP-4i for hypoglycemic treatment in T2DM patients may result in mild elevation of blood Cr lev-els.Further multicenter studies with larger samples are needed in the future to explore the clinical significance of DPP-4i treatment induced changes in Cr levels.

dipeptidyl peptidase-4 inhibitortype 2 diabetes mellituscreatininerandomized controlled trial

尚蓓蓓、杨禹、刘长彬、张冬雷、柳鑫

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首都儿科研究所附属儿童医院药学部,北京市 100020

首都医科大学附属北京天坛医院心脏及大血管病中心,北京市 100070

首都医科大学附属北京天坛医院康复科,北京市 100070

武汉大学附属中南医院血液科,湖北省武汉市 430071

首都医科大学附属北京天坛医院药学部,北京市 100070

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二肽基肽酶4抑制剂 2型糖尿病 肌酐 随机对照试验

国家自然科学基金国家自然科学基金

8170011582102676

2024

中国动脉硬化杂志
中国病理生理学会 南华大学

中国动脉硬化杂志

CSTPCD
影响因子:1.086
ISSN:1007-3949
年,卷(期):2024.32(8)
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