恩格列净对2型糖尿病患者血脂影响的系统评价

Effect of Empagliflozin on Serum Lipid in Patients with Type 2 Diabetes Mellitus: a Systematic Review

目的评价恩格列净对2型糖尿病患者血脂的影响。方法计算机检索PubMed,Embase,Medline,Cochrane Library,CNKI,Wanfang,VIP等数据库,检索时限自建库至2017年7月,筛选恩格列净对比其他降糖药物治疗2型糖尿病对血脂影响的随机对照试验(RCT),根据纳入和排除标准筛选文献,提取资料,并进行质量评价,采用RevMan 5. 3软件进行Meta分析。结果共纳入RCT 13篇,2型糖尿病患者4 716例,纳入研究质量高; Meta分析结果显示,干预组相比于对照组2型糖尿病患者三酰甘油降低[MD=-0. 19,95%CI(-0. 20,-0. 18),P <0. 000 01],高密度脂蛋白胆固醇升高[MD=0. 06,95%CI(0. 05,0. 07),P=0. 002],血清总胆固醇升高[MD=0. 06,95%CI(0. 05,0. 07),P <0. 000 01],低密度脂蛋白胆固醇升高[MD=0. 06,95%CI(0. 02,0. 10),P=0. 002]。结论与其他降糖药物相比,恩格列净不能降低2型糖尿病患者的血清总胆固醇和低密度脂蛋白胆固醇,不推荐2型糖尿病合并高脂血症患者使用。

Objective To evaluate the effect of empagliflozin on serum lipid in patients with type 2 diabetes mellitus( T2 DM). Methods Such databases as PubMed,Embase,Medline,Cochrane Library,CNKI,Wanfang and VIP from inception to July 2017 were searched to screen the random controlled trials( RCTs) of empagliflozin on serum lipid in patients with T2 DM. According to the inclusion and exclusion criteria,literature was screened,the corresponding data were extracted and quality evaluation was carried out. Meta-analysis was performed by using RevMan 5. 3 software. Results Totally 13 RCTs of empagliflozin in the treatment of T2 DM were included,including 4 716 patients with T2 DM,and the quality of the included studies was high. Meta-analysis showed that compared with the control group,the triglyceride decreased [ MD =-0. 19,95 % CI(-0. 20,-0. 18),P < 0. 000 01 ],the high density lipoprotein cholesterol( HDL-C) increased [ MD = 0. 06,95 % CI( 0. 05,0. 07,P = 0. 002 ],serum total cholesterol increased [ MD =0. 06,95 % CI( 0. 05,0. 07),P < 0. 000 01 ] and low density lipoprotein cholesterol( LDL-C) increased [ MD = 0. 06,95 % CI( 0. 02,0. 10),P = 0. 002 ] in patients with T2 DM in the intervention group. Conclusion Compared with other hypoglycemic drugs,empagliflozin can not reduce serum total cholesterol and LDL-C in patients with T2 DM. It is not recommended to use empagliflozin in patients with T2 DM complicated with hyperlipidemia.