司美格鲁肽对肥胖合并或不合并糖尿病患者心血管结局的影响:基于随机对照试验的meta分析  

Effects of semaglutide on cardiovascular outcomes in patients with obesity with or without diabetes:a meta-analysis based on randomized controlled trials

作　　者：何贵均 刘汉雄[1] 张震[1] HE Guijun;LIU Hanxiong;ZHANG Zhen(Department of Cardiology,Chengdu Third People's Hospital,Chengdu,610000,China)

机构地区：[1]成都市第三人民医院心内科,成都610000

出　　处：《临床心血管病杂志》2025年第3期213-218,共6页Journal of Clinical Cardiology

摘　　要：目的:探讨司美格鲁肽对伴或不伴糖尿病的肥胖症患者心血管预后的影响。方法:检索Pubmed、Embase和Cochrane图书馆的数据库,纳入体重指数(BMI)>30 kg/m2、伴或不伴糖尿病的患者,使用RevMan 5.4进行荟萃分析。结果:最终纳入7项随机对照研究,共计29275例。与安慰剂相比,在伴或不伴糖尿病的肥胖症患者中,司美格鲁肽显著减少主要不良心血管事件(major adverse cardiovascular events,MACE)(OR=0.81,95%CI:0.74~0.88,P<0.001)、全因死亡(OR=0.80,95%CI:0.72~0.89,P<0.001)、心血管死亡(OR=0.80,95%CI:0.69~0.92,P=0.001)、心力衰竭(OR=0.86,95%CI:0.75~0.99,P=0.04)和严重不良事件(OR=0.86,95%CI:0.82~0.90,P<0.001)。与安慰剂相比,司美格鲁肽导致治疗中断的不良事件发生率明显升高(OR=1.63,95%CI:1.20~2.20,P=0.002)。结论:司美格鲁肽可降低MACE、全因死亡、心血管死亡、心力衰竭以及严重不良事件的发生率,但会增加治疗中断的不良事件。Objective To explore the effect of semaglutide on cardiovascular outcomes in obese patients with or without diabetes.Methods Databases from Pubmed,Embase and the Cochrane Library were searched.We recruited patients with a body mass index(BMI)greater than 30 kg/m2,with or without diabetes.A meta-analysis was performed using RevMan 5.4.Results A total of 7 randomized controlled trials involving 29275 participants were included.Compared to placebo,semaglutide significantly reduced major adverse cardiovascular events(MACE)in obese patients with or without diabetes(OR=0.81,95%CI:0.74 to 0.88,P<0.001).It also reduced all-cause mortality(OR=0.80,95%CI:0.72 to 0.89,P<0.001),cardiovascular mortality(OR=0.80,95%CI:0.69 to 0.92,P=0.002),heart failure(OR=0.86,95%CI:0.75 to 0.99,P=0.04),and serious adverse events(OR=0.86,95%CI:0.82 to 0.90,P<0.001).However,semaglutide was associated with a significantly higher incidence of adverse events leading to treatment discontinuation compared to placebo(OR=1.63,95%CI:1.20 to 2.20,P=0.002).Conclusion Semaglutide may reduce the incidence of MACE,all-cause mortality,cardiovascular mortality,heart failure,and serious adverse events,but it increases the risk of adverse events leading to treatment discontinuation.

关 键 词：司美格鲁肽 心血管结局 肥胖症 糖尿病 

分 类 号：R54[医药卫生—心血管疾病]