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    SGLT2抑制剂联合DPP-4抑制剂治疗2型糖尿病有效性的Meta分析

    The efficacy of sodium glucose co-transporter 2 inhibitor combined with dipeptidyl peptidase-4 inhibitor in treating type 2 diabetes mellitus: a meta-analysis of randomized controlled trials

    • 摘要: 目的 系统评价钠-葡萄糖协同转运蛋白2(SGLT2)抑制剂联合二肽基肽酶-4(DPP-4)抑制剂治疗2型糖尿病患者的有效性和安全性。方法 计算机检索PubMed、Cochrane Library、EMBASE、万方数据库、维普、中国知网以及中国生物医学文献数据库收录的公开发表的相关随机对照试验(RCT),检索时限为建库以来至2019年12月。由2位评价员独立筛选文献、提取资料并评价纳入研究的偏倚风险后,采用RevMan 5.3和Stata 14.0软件进行Meta分析。结果 共纳入14篇文献,5 110名患者。Meta分析结果显示:SGLT2抑制剂联合DPP-4抑制剂组在降低糖化血红蛋白(HbA1c)〔MD=-0.71,95%CI(-0.82,-0.61),P<0.00001〕、体质量(BW)〔MD=-1.97,95%CI(-2.15,-1.79),P<0.00001〕方面明显优于对照组。结论 SGLT2抑制剂联合DPP-4抑制剂可更有效降低2型糖尿病患者的HbA1c、BW水平,且与疗程长短、背景用药及SGLT2抑制剂种类无关。

       

      Abstract: Objective To systematically evaluate the efficacy and safety of sodium-glucose co-transporter 2 (SGLT2) inhibitor combined with dipeptidyl peptidase-4 (DPP-4) inhibitor in the treatment of type 2 diabetes patients. Methods PubMed, Cochrane Library,EMBASE, the WeiPu (VIP), the China National Knowledge Infrastructure (CNKI) and China Biology Medicine disc (CBMdisc) were used for searching relevant randomized controlled trials published till December, 2019. Two reviewers independently screened literature, extracted data, and assessed the risk of bias of included studies. Then meta-analysis was performed using RevMan 5.3 software and Stata1 4.0 software. Results A total of 14 studies were included, involving 5 110 patients. Meta analysis showed that the SGLT2 inhibitor combined with DPP-4 inhibitor group was significantly better than the control group in reducing glycosylated hemoglobin (HbA1c) MD=-0.71, 95% CI (-0.82, -0.61), P<0.00001, body weight (BW) MD =-1.97, 95% CI (-2.15, -1.79), P<0.00001. Conclusions SGLT2 inhibitor combined with DPP-4 inhibitor can effectively reduce the glycosylated hemoglobin and body weight in type 2 diabetic patients. This effect will not be different due to the length of treatment course, background medication and the type of SGLT2 inhibitor.

       

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