二甲双胍治疗Ⅱ型糖尿病前后血清脂联素水平变化:Meta分析

Changes of Serum Adionectin Levels before and after Metformin Therapy for Patients with the Type 2 Diabetes:Meta Analysis

目的:系统评价二甲双胍对Ⅱ型糖尿病血清脂联素水平的影响。方法:以"二甲双胍""2型糖尿病""脂联素"等为中文关键词,在维普网、中国知网及万方数据库筛选相关中文文献,以"metformin""Type 2 diabetes""Adiponectin"等为外文关键词,在pubmed数据库筛选相关外文文献,用Meta分析的方法比较治疗前后脂联素水平的变化,以加权均数差(WMD)及95%的可信区间(CI)表示。结果:共纳入文献9篇,Meta分析结果为WMD=2.63,95%CI[2.043.21],P<0.05,I2>50%,提示二甲双胍治疗后可显著提高ADP的水平,但纳入的研究存在统计学异质性。进一步以药物疗程进行亚组分析,发现血清脂联素水平在二甲双胍治疗12 w后无明显变化,但在治疗24 w后显著增加,而两组文献均无统计学异质性(I2<50%)。结论:二甲双胍能上调糖尿病患者血清ADP水平,且存在干预时间依赖性。

Objective:To systematically review the effect of metformin on serum adiponectin levels in type 2 diabetes.Methods:With"metformin","type 2 diabetes","adiponectin",etc.as chinese keywords,the relevant chinese literature were screened on Weipu.com,CNKI and Wanfang databases.With the above words as foreign keywords,the relevant foreign language documents in the pubmed database were screened.Meta-analysis was used to compare the changes in adiponectin levels before and after treatment,expressed by weighted mean difference(WMD)and 95%confidence interval(CI).Results:A total of 9 articles were included.The result of the Meta analysis was WMD=2.63,95%CI was(2.04,3.21),P<0.05,I2>50%.It suggested that metformin treatment could significantly increase the level of ADP,but the included studies were statistically heterogeneous.Further subgroup analysis based on the course of drug treatment revealed that the serum adiponectin level did not change significantly after 12 weeks of metformin treatment,but it increased significantly after 24 weeks of treatment,and there was no statistical heterogeneity in the two groups of literature(I2<50%).Conclusion:Metformin can up-regulate serum ADP levels in diabetic patients,and there is a timedependent intervention.