2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。"/>

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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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(1.首都儿科研究所附属儿童医院药学部,北京市 100020;2.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;3.首都医科大学附属北京天坛医院康复科,北京市 100070;4.武汉大学附属中南医院血液科,湖北省武汉市 430071;5.首都医科大学附属北京天坛医院药学部,北京市 100070)

作者简介:

尚蓓蓓,主管药师,研究方向为心血管疾病药物的循证研究,E-mail:beibeiami@126.com。

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国家自然科学基金(81700115、82102676)


Meta-analysis of the effect of dipeptidyl peptidase-4 inhibitor on creatinine level in type 2 diabetes patients
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Affiliation:

1.Department of Pharmacy, Children's Hospital, Capital Institute of Pediatrics, Beijing 100020, China;2.Center of Heart and Macrovascular Disease, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China;3.Department of Rehabilitation, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China;4.Department of Hematology, Zhongnan Hospital, Wuhan University, Wuhan, Hubei 430071, China;5.Department of Pharmacy, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China)

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    摘要:

    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。

    Abstract:

    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 databases 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, I2=18%, 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 levels. 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.

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尚蓓蓓,杨禹,刘长彬,张冬雷,柳鑫.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[J].中国动脉硬化杂志,2024,32(8):697~704.

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  • 收稿日期:2024-07-03
  • 最后修改日期:2024-07-09
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  • 在线发布日期: 2024-08-21
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