胰升血糖素样肽1受体激动剂对2型糖尿病患者血压影响的Meta分析  

Meta-analysis of the effect of glucagon-like peptide-1 receptor agonist on type 2 diabetic patients blood pressure

作　　者：肖胜群 刘建英 XIAO Shengqun;LIU Jianying(Department of Endocrinology,The First Affiliated Hospital of Nanchang University,Nanchcmg 330000,China)

机构地区：[1]南昌大学第一附属医院内分泌科,330000

出　　处：《中国糖尿病杂志》2021年第7期513-527,共15页Chinese Journal of Diabetes

摘　　要：目的系统评价胰升血糖素样肽1受体激动剂(GLP-1 RA)对T2DM患者BP的影响。方法计算机检索PubMed、Embase、Cochrane Library、Web of science,根据纳入及排除标准筛选出GLP-1 RA对T2DM患者BP水平影响的随机对照试验(RCT)。采用RevMan 5.3软件进行统计学分析。结果最终纳入18项安慰剂对照的RCT研究,Meta分析结果显示,GLP-1受体激动剂降低SBP(MD=―2.95,95%CI-3.60~-2.30,P<0.00001,I2=27%),DBP差异无统计学意义(MD=-0.41,95%CI-0.83~0.01,P=0.05,I2=22%];在改善BP方面,与人GLP-1氨基酸序列同源性低的药物可能优于同源性高的;短效制剂改善BP可能要优于长效制剂。结论 GLP-1受体激动剂对T2DM患者血压的影响主要表现为降低SBP。Objective To systematically evaluate the effect of glucagon-like peptide-1 receptor agonists(GLP-1 RA)on blood pressure in patients with type 2 diabetes mellitus(T2 DM).Methods We searched multiple database including PubMed,Embase,Cochrane Library and Web of science to collect randomized controlled trials(RCTs)according to study inclusion and exclusion criteria to evaluate the effects of GLP-1 RA on blood pressure in T2 DM patients. Statistical analysis was performed using RevMan 5. 3 software.Results Eighteen placebo-controlled RCT studies were included. Meta analysis results suggest that,SBP was lower in GLP-1 RA group(MD=-3. 08,95% CI-3. 60~-2. 30,P<0. 00001,I2=27%).There was no significant difference in DBP between the GLP-1 RA group and the control group(MD=-0. 41,95% CI-0. 83~0. 01,P=0. 05,I2=22%). In improving blood pressure,drugs with low amino acid sequence homology to human GLP-1 may be superior to those with high homology,and short-acting preparations may be better than long-acting preparations.Conclusion The main manifestation of the effect of GLP-1 RA on blood pressure in T2 DM patients is the decrease of SBP.

关 键 词：糖尿病 2型 胰升血糖素样肽1受体激动剂 血压 META分析 

分 类 号：R587.1[医药卫生—内分泌]