摘要
We conducted a systematic review and meta-analysis of randomized controlled trials（RCTs） to determine the effectiveness and safety of incretin-based therapies（IBTs） for the treatment of type 2 diabetes（T2DM） with nonalcoholic fatty liver disease（NAFLD）. Electronic databases such as the Cochrane library, EMbase, Pub Med, and three Chinese databases were searched for RCTs that compared IBTs with other treatments or placebo for T2 DM with NAFLD. Two reviewers independently assessed the risk of bias, extracted, and analyzed the data. A meta-analysis was performed using Revman 5.2. Publication bias was evaluated. Seven RCTs involving 532 patients were ultimately included. The results of meta-analysis（random-effects model） revealed that IBTs had a significant reduction in serum ALT（WMD –12.30, 95% CI –17.53~–7.06） and BMI（WMD –2.64, 95% CI –4.35~–0.94）. However, there was no significant difference in other outcomes including Hb A1 c, AST, TC, TG and HOMA-RA. IBTs were well tolerated by patients but the evidence was limited. The significant decrease in hepatic biochemical markers following treatment with IBTs, as well as improvements in BMI, suggested that IBTs may be an effective option for T2 DM with NAFLD.
本文旨在对基于肠促胰素药物治疗2型糖尿病合并非酒精性肝病的疗效和安全性进行系统评价和meta分析。全面检索Cochrane Library、EMBASE、Pub Med、CNKI、中国生物医学文献数据库CBM和万方中华医学会期刊数据库,纳入2015年7月之前发表的全部随机对照试验（RCT）。共纳入7个RCT的532名患者（干预组：264,对照组：268）。肠促胰素组显著降低患者谷丙转氨酶ALT（WMD–12.30,95%CI–17.53~–7.06）和BMI（WMD–2.64,95%CI–4.35~–0.94）。两组对患者血红蛋白（Hb A1c%）、天门冬氨酸转移酶（AST）、总胆固醇（TC）、甘油三酯（TG）和胰岛素抵抗指数（HOMA-RA）的改变无显著差别。有限的安全性资料显示不良反应可耐受。基于肠促胰素药物对ALT和BMI的改善效果较好,安全性尚可,可作为2型糖尿病合并非酒精性肝病患者的治疗选择,但研究质量有限。
