西格列汀治疗2型糖尿病疗效和安全性的Meta分析

The efficacy and safety of sitagliptin in the treatment of type 2 diabetes:A meta analysis

目的评价西格列汀治疗T2DM的疗效和安全性。方法通过检索数据库最终纳入12项随机对照试验并进行Meta分析。结果与安慰剂相比,西格列汀可降低HbA1c(WMD=-0.77,95%CI:-0.89^-0.66,P<0.01)、FPG(WMD=-1.25,95%CI:-1.50^-1.01,P<0.01)、2hPG(WMD=-2.61,95%CI:-3.04^-2.17,P<0.01)。西格列汀降低HbA1c效果较GLP-1类似物差(WMD=0.47,95%CI:0.32~0.63,P<0.01),降低FPG效果较GLP-1类似物、二甲双胍差(WMD=1.25,95%CI:0.99~1.52,P<0.01;WMD=0.88,95%CI:0.56~1.20,P<0.01)。西格列汀降低低血糖发生率与安慰剂比较差异无统计学意义(RR=1.44,95%CI:0.79~2.62,P=0.23)。结论西格列汀可有效控制T2DM患者血糖,且低血糖发生率低,但降糖效果较GLP-1类似物、二甲双胍差。

Objective To assess the efficacy and safety of sitagliptin in the treatment of T2DM.Methods Retrieval with computer from the medicine databases,a total of twelve studies were selected,and meta analysis was performed.Results Compared with placebo,HbA1c,FPG,2 hPG were decreased with sitagliptin treatment （WMD--0.77,95％CI：-0.89～-0.66,P＜0.01 ;WMD=-1.25,95％CI：-1.50～-1.01,P＜0.01;WMD=2.61,95％CI：-3.04～-2.17,P＜0.01）.Sitagliptin was less effective in reducing HbA1c when compared with GLP-1 analogue （WMD =0.47,95％ CI：0.32 ～ 0.63,P＜ 0.01）.Sitagliptin was also less effective in reducing FPG when compared with GLP-1 analogue and metformin （WMD=1.25,95％CI：0.99～1.52,P＜0.01 ;WMD =0.88,95％CI：0.56～1.20,P＜0.01）.There was no statistically significant difference in the risk of hypoglycemia with sitagliptin,compared to placebo （RR=1.44,95％ CI：0.79 ～ 2.62,P =0.23）.Conclusion Sitagliptin is effective in glycemic control with a low risk of hypoglycemia for T2DM patients,but sitagliptin is less effective in reducing blood glucose when compared with GLP-1 analogue and metformin.