瑞格列奈治疗肥胖与非肥胖2型糖尿病的Meta分析  

Meta-analysis of repaglinide in treatment of obese and non-obese patients with type 2 diabetes

作　　者：卫晋菲[1] 周亮[1] 王明媚[1] 王心慧[1] 张鑫[1] 王晓青[1] WEI Jin-fei;ZHOU Liang;WANG Ming-mei;WANG Xin-hui;ZHANG Xin;WANG Xiao-qing(First Hospital Affiliated to General Hospital of PLA, Beijing 100048, China)

机构地区：[1]解放军总医院第一附属医院药剂药理科,北京100048

出　　处：《中国药物应用与监测》2017年第4期201-205,共5页Chinese Journal of Drug Application and Monitoring

基　　金："十二五"国家科技支撑计划课题(2013BAI06B04)

摘　　要：目的:探讨比较瑞格列奈治疗肥胖与非肥胖2型糖尿病(T2DM)的疗效和安全性。方法:计算机检索PubMed、EMbase、Cochrane图书馆、万方、维普、CNKI,查找瑞格列奈治疗肥胖与非肥胖T2DM的研究,由2名研究人员严格按照纳入与排除标准对文献进行筛选、数据提取和质量评价后,采用RevMan 5.2软件进行Meta分析。结果:共纳入6项临床对照试验(CCT),789例患者。Meta分析结果显示:在降低糖化血红蛋白[MD=–0.35,95%CI(–0.54,–0.15),P=0.000 5]和体重指数[MD=–3.33,95%CI(–4.12,–2.54),P<0.000 01]方面,肥胖组优于非肥胖组;在降低FPG[MD=–0.26,95%CI(–0.76,0.24),P=0.31]和2hPG[MD=–0.21,95%CI(–1.18,0.76),P=0.68]方面,肥胖组与非肥胖组方面的差异无统计学意义;非肥胖组的不良反应[RR=0.27,95%CI(0.10,0.71),P=0.008]发生风险高于肥胖组。各项结局指标的异质性结果分别为:HbA1c[P=0.60,(P>0.10),I^2=0%)]、FPG[P=0.01(P<0.10),I^2=66%]、2 hPG[P=0.001(P<0.10),I^2=75%]、BMI[P=0.62(P>0.10),I^2=0%]、ADR[P=0.44(P>0.10),I^2=0%]。结论:瑞格列奈治疗肥胖型2型糖尿病患者的疗效优于非肥胖型,且其不良反应发生率更低。Objective:To evaluate the efficacy and safety of repaglinide in the treatment of obese and non-obese patientswith type2diabetes(T2DM).Methods:Databases from PubMed,EMbase,The Cochrane Library,Wanfang,VIP and CNKI weresearched to extract the studies about repaglinide in the treatment of obese and non-obese patients with T2DM.After the screening,according to the inclusion and exclusion criteria,the data extracting and quality evaluating were performed by2researchers,andthen meta-analysis was performed using RevMan5.2software.Results:A total of6controlled clinical trials(CCT)including789patients involved in the study.The results of meta-analysis showed that the effects of repaglinide in lowering HbAlc[MD=–0.35,95%CI(–0.54,–0.15),P=0.0005]and BMI[MD=–3.33,95%CI(–4.12,–2.54),P<0.00001]in obese group were better thanthose in the non-obese group.However,repaglinide showed similar effects of lowering FPG[MD=–0.26,95%CI(–0.76,0.24),P=0.31]and2hPG[MD=–0.21,95%CI(–1.18,0.76),P=0.68]in both obese group and non-obese group.The risk of ADR in non-obesegroup was higher than that in obese group[RR=0.27,95%CI(0.10,0.71),P=0.008].The results of heterogeneity were as follows:HbA1c[P=0.60,(P>0.10),I2=0%)],FPG[P=0.01(P<0.10),I2=66%],2hPG[P=0.001(P<0.10),I2=75%],BMI[P=0.62(P>0.10),I2=0%]and ADR[P=0.44(P>0.10),I2=0%].Conclusion:The effect of repaglinide in the treatment of obese patientswith T2DM was more effective than that in non-obese patients with T2DM,while the risk of ADR was lower.

关 键 词：瑞格列奈 肥胖 2型糖尿病 META分析 

分 类 号：R587.1[医药卫生—内分泌]