利拉鲁肽对2型糖尿病患者脂肪分布影响的Meta分析

Effect of liraglutide on fat distribution in patients with type 2 diabetes mellitus:a Meta-analysis

目的系统评价利拉鲁肽对2型糖尿病患者脂肪分布的影响。方法检索美国国立医学图书馆(PubMed)、Cochrane循证医学数据库(Cochrane Library)、医学文摘数据库(Embase)、中国期刊全文数据库(CNKI)、万方数据库、维普数据库,选择从建库至2021年12月发表的有关利拉鲁肽治疗2型糖尿病的随机对照试验,根据纳入排除标准筛选符合标准的研究,并提取相关数据。试验组使用利拉鲁肽,对照组使用安慰剂、活性药物、饮食干预或为基础药物对照。研究的主要结局指标为内脏脂肪组织和皮下脂肪组织,并评估其他人体测量指标,包括体重、腰围及体重指数。采用Review Manager 5.4.1和STATA 16.0进行统计学分析,Egger检验评估发表偏倚,Cochrane偏倚风险评估工具评估偏倚风险。结果最终纳入8篇文献,包括10项随机对照试验。荟萃分析结果显示,与对照组相比,利拉鲁肽组可显著降低内脏脂肪组织[标准化均值差(SMD)=-0.69 cm^(2),95%CI-1.09~-0.29 cm^(2),I^(2)=78%,P<0.05]和皮下脂肪组织(SMD=-0.48 cm^(2),95%CI-0.77~-0.19 cm^(2),I^(2)=50%,P<0.05),另外也显著降低了体重[加权均值差(WMD)=-3.65 kg,95%CI-4.45~-2.85 kg,I^(2)=0,P<0.05]、腰围(WMD=-3.07 cm,95%CI-4.63~-1.51 cm,I^(2)=75%,P<0.05)及体重指数(WMD=-1.23 kg/m2,95%CI-1.62~-0.84 kg/m2,I^(2)=50%,P<0.05)。结论利拉鲁肽可显著降低内脏脂肪和皮下脂肪。

Objective To systematically evaluate the effect of liraglutide on fat distribution in patients with type 2 diabetes mellitus.Methods Databases of PubMed,the Cochrane Library,Embase,CNKI,Wanfang and VIP were searched for randomized controlled trials(RCT)with therapy of liraglutide in type 2 diabetes mellitus from establishment of the database to December 2021,and the eligible studies were screened according to the inclusion and exclusion criteria,and the relevant data were extracted.The experimental group received liraglutide,and the control group received placebo,active drug,dietary intervention or basal drug control.The primary outcome measures were visceral and subcutaneous adipose tissue,as well as other anthropometric measures,including body weight,waist circumference and body mass index.The Review Manager 5.4.1 and STATA 16.0 for statistical analysis were performed.Egger′s test assessed publication bias.The Cochrane risk of bias tool assessed the risk of bias.Results A total of 8 articles including 10 RCT were included.The results of the meta-analysis showed that compared with the control group,the liraglutide group had a significant reduction in visceral adipose tissue[standardized mean difference(SMD)=-0.69 cm^(2),95%CI-1.09--0.29 cm^(2),I^(2)=78%,P<0.05]and subcutaneous adipose tissue(SMD=-0.48 cm^(2),95%CI-0.77--0.19 cm^(2),I^(2)=50%,P<0.05).In addition,it also significantly reduced body weight[weighted mean difference(WMD)=-3.65 kg,95%CI-4.45--2.85 kg,I^(2)=0,P<0.05],waist circumference(WMD=-3.07 cm,95%CI-4.63--1.51 cm,I^(2)=75%,P<0.05)and body mass index(WMD=-1.23 kg/m2,95%CI-1.62--0.84 kg/m2,I^(2)=50%,P<0.05).Conclusion Liraglutide significantly reduced visceral and subcutaneous fat.