二肽基肽酶-4抑制药对2型糖尿病患者血脂影响的Meta分析

Effects of Dipeptidyl Peptidase-4 Inhibitors on Lipids in Patients with Type 2 Diabetes Mellitus:A Meta-analysis

目的系统评价二肽基肽酶-4抑制药对2型糖尿病患者血脂的影响。方法利用计算机检索建库至2017年2月Pub Med、Cochrane Library、中国生物医学文献数据库(CBM)、中国期刊全文数据库(CNKI)及万方期刊数据库,选择符合纳入及排除标准的随机对照试验,采用Rev Man 5.0版和Stata12.0版软件进行Meta分析。结果共38篇随机对照试验研究纳入分析。Meta分析结果显示:与对照组比较,二肽基肽酶-4抑制药单独或联合使用能够降低2型糖尿病患者血清总胆固醇[WMD=-0.13 mmol·L-1,95%CI(-0.19,-0.07)mmol·L-1,P<0.000 1]、三酰甘油[WMD=-0.17 mmol·L-1,95%CI(-0.25,-0.09)mmol·L-1,P<0.000 1],低密度脂蛋白胆固醇[WMD=-0.08 mmol·L-1,95%CI(-0.13,-0.03)mmol·L-1,P=0.003 0],但对高密度脂蛋白胆固醇[WMD=-0.01 mmol·L-1,95%CI(-0.04,0.01)mmol·L-1,P=0.280 0]无影响;亚组分析表明联合用药相比单一用药能够更加显著地降低血清总胆固醇、三酰甘油和低密度脂蛋白胆固醇。结论二肽基肽酶-4抑制药单独或联合用药能够降低2型糖尿病患者的血清总胆固醇、三酰甘油和低密度脂蛋白胆固醇。

Objective To evaluate the effects of dipeptidyl peptidase-4 inhibitors on serum lipids in patients with type2 diabetes mellitus. Methods Randomized controlled trials of related articles from inception to February 2017 were searched from Pub Med,Cochrane Library,CBM,CNKI and Wangfang by computer. Meta-analysis was performed using Rev Man 5. 0 and Stata12.0 software. Results A total of 38 randomized controlled trials were identified.The results showed that as compared with controls,dipeptidyl peptidase-4 inhibitors alone or in combination significantly improved serum total cholesterol [WMD =-0.13 mmol·L-1,95%CI（-0.19,-0.07） mmol·L-1,P〈0.000 1],triglycerides [WMD=-0.17 mmol·L-1,95%CI（-0.25,-0.09） mmol·L-1,P〈0.000 1] and low-density lipoprotein cholesterol [WMD =-0.08 mmol·L-1,95%CI（-0.13,-0.03）mmol·L-1,P = 0.003 0].However,no statistical significances were observed in high-density lipoprotein cholesterol [WMD =-0.01 mmol·L-1,95%CI（-0. 04,0. 01） mmol·L-1,P = 0. 280 0]. Subgroup analysis revealed that dipeptidyl peptidase-4 inhibitors in combination achieved greater improvement in serum total cholesterol,triglycerides and low-density lipoprotein cholesterol levels. Conclusion Dipeptidyl peptidase-4 inhibitors alone or in combination significantly improve serum total cholesterol,triglycerides and low-density lipoprotein cholesterol in patients with type 2 diabetes mellitus.