SGLT2抑制剂对心血管风险患者炎症因子水平影响的Meta分析  

Influence of inhibitor of sodium-glucose cotransporter 2 on inflammatory factors in patients with cardiovascular risk:a Meta-analysis

作　　者：杨小凤 王林江 陈颖 牟川 袁媛[1] 王浩宇[1] Yang Xiaofeng;Wang Linjiang;Chen Ying;Mou Chuan;Yuan Yuan;Wang Haoyu(Department of Cardiovascular Medicine,Central Hospital of Nanchong City,Second Clinical Medical College,North Sichuan Medical College,Nanchong 637000,China.)

机构地区：[1]川北医学院第二临床医学院南充市中心医院心血管内科,南充637000

出　　处：《中国循证心血管医学杂志》2025年第2期153-160,共8页Chinese Journal of Evidence-Based Cardiovascular Medicine

摘　　要：目的系统评价钠-葡萄糖协同转运蛋白2(SGLT2)抑制剂对心血管风险患者炎症因子水平的影响。方法计算机检索PubMed、Cochrane Library、EMbase和Web of Science数据库中以“sodium glucose transporter 2 inhibitors”、“inflammation”及“inflammatory biomarkers”等检索词,搜索了所有关于SGLT2抑制剂对炎症因子水平影响的随机对照试验(RCT),检索时间为数据库建立之日至2023年11月30日,筛选并纳入相关文献,使用RevMan5.4软件进行Meta分析。结果共纳入23篇文献,共计2766例患者(男性占比61.3%),其中SGLT2抑制剂治疗组1491例,安慰剂或常规药物治疗对照组1275例。Meta分析结果显示:①与对照组相比,SGLT2抑制剂的治疗能够降低心血管风险患者炎症因子超敏C反应蛋白(hs-CRP)水平[标准化均数差(SMD):-0.21;95%置信区间(CI):-0.39~-0.03,P=0.02]、肿瘤坏死因子-α(TNF-α),加权均数差[(WMD:-0.63;95%CI:-0.95~-0.32,P<0.0001)]以及白细胞介素-6[(IL-6,WMD=-0.55,95%CI:-0.84~-0.26,P=0.0002)]水平均降低;②亚组分析结果显示,在非吡格列酮对照组中,SGLT2抑制剂组提高了脂联素水平(SMD=0.17,95%CI:0.02~0.32,P=0.02);③SGLT2抑制剂对瘦素的影响无统计学意义(P>0.05)。结论SGLT2抑制剂的治疗能够降低心血管风险患者炎症因子hs-CRP、TNF-α以及IL-6的水平,提高血清脂联素水平。SGLT2抑制剂在心血管风险患者中显示出抗炎作用,有望改善患者心血管事件及远期预后。Objective To review systematically the influence of inhibitor of sodium-glucose cotransporter 2(SGLT2)on inflammatory factors in patients with cardiovascular risks.Methods The databases of PubMed,Cochrane Library,EMbase and Web of Science were retrieved with computer taken“sodium glucose transporter 2 inhibitors”,“inflammation”and“inflammatory biomarkers”as search terms.All randomized controlled trials(RCT)related to influence of SGLT2 on levels of inflammatory factors were searched from database establishment time to Nov.30,2023.All relative literature was screened and included,and given a Meta-analysis by using RevMan5.4 software.Results There were totally 23 RCT included with 2766 patients(including 61.3%of male),and there were 1491 patients in SGLT2 inhibitor group and 1275 in control group.The results of Meta-analysis showed that the levels of high sensitivity C-reactive protein(hs-CRP,SMD:-0.21,95%CI:-0.39~-0.03,P=0.02),tumor necrosis factor-α(TNF-α),[(WMD:0.63,95%CI:-0.95~-0.32,P<0.0001)],and interleukin-6[(IL-6,WMD:-0.55,95%CI:-0.84~-0.26,P=0.0002)]decreased in SGLT2 inhibitor group compared with control group.The results of subgroup analysis showed that the level of adiponectin increased(SMD=0.17,95%CI:0.02~0.32,P=0.02)in SGLT2 inhibitor group compared with non-pioglitazone control group.The influence of SGLT2 inhibitor group on leptin had no statistical significance(P>0.05).Conclusion SGLT2 inhibitor can reduce the levels of inflammatory factors including hs-CRP,TNF-αand IL-6,and raise adiponectin level,and its anti-inflammatory effect is expected to relieve cardiovascular events and improve long-term prognosis in patients with cardiovascular risks.

关 键 词：钠-葡萄糖协同转运蛋白2抑制剂 心血管疾病 炎症 META分析 随机对照试验 

分 类 号：R4[医药卫生—临床医学]