利拉鲁肽对2型糖尿病合并非酒精性脂肪肝疗效的荟萃分析

Efficacy of Liraglutide in Treatment of Type 2 Diabetes with Nonalcoholic Fatty Liver: A Meta-analysis

目的 系统评价利拉鲁肽对2型糖尿病(T2DM)合并非酒精性脂肪肝(NAFLD)的疗效。 方法 检索PubMed、Embase、万方数据库、中国知网、维普等数据库相关文献,检索时限均从建库至2018年6月,并对其进行质量评价、资料提取,采用RevMan 5.3软件进行文献异质性检验、Meta分析。 结果 共纳入10篇随机对照试验,共716例患者,对照组352例,利拉鲁肽组364例。 Meta分析结果显示,利拉鲁肽组肝脏脂肪含量低于对照组( WMD = -5.84,95% CI -7.58^-4.10, P <0.000 01),B超分数低于对照组( WMD =-0.98,95% CI -1.13^-0.83, P <0.000 01),三酰甘油水平低于对照组( WMD =-0.50,95% CI -0.56^-0.43, P <0.000 01),总胆固醇水平低于对照组( WMD =-1.28,95% CI -1.38^-1.19, P <0.000 01),天冬氨酸转氨酶水平低于对照组( WMD =-3.95,95% CI -4.94^-2.96, P <0.000 01),糖化血红蛋白(HbA 1c )水平低于对照组( WMD =-0.92,95% CI -1.09^-0.75, P <0.000 01)。 结论 利拉鲁肽能有效降低T2DM合并NAFLD患者的脂肪含量、血脂、HbA 1c ,并能改善肝酶学指标,对T2DM合并NAFLD有显著疗效。

Objective To systematically evaluate the efficacy of liraglutide in type 2 diabetes(T2DM) combined with nonalcoholic fatty liver disease(NAFLD). Methods We searched related literatures in PubMed,Embase,Wanfang,CNKI,and VIP databases published from establishment to June 2018.The quality of each article was evaluated and data was extracted .Heterogeneity test and Meta-analysis were performed using RevMan 5.3 software. Results Ten randomized controlled trials were included for this meta-analysis.Data of 716 patients (352 in normal control group and 364 in liraglutide-treated group) were analyzed.Meta-analysis results indicated that the liver fat content( WMD =-5.84,95% CI -7.58- -4.10 , P <0.000 01),ultrasound B-line score( WMD =-0.98,95% CI -1.13--0.83, P <0.000 01),triglyceride( WMD =-0.50,95% CI -0.56--0.43, P <0.000 01),total cholesterol( WMD =-1.28,95% CI -1.38--1.19, P <0.000 01),aspartate aminotransferase( WMD =-3.95,95% CI -4.94--2.96, P <0.000 01) and glycated hemoglobin(HbA 1c )( WMD =-0.92,95% CI -1.09--0.75, P <0.000 01) levels of liraglutide-treated group were significantly lower than those in the control group. Conclusion Liraglutide can effectively alleviate the liver fat content,hyperlipi- demia,HbA 1c and liver enzymologic index in T2DM patients complicated with NAFLD,indicating its significant therapeutic efficacy .