SGLT-2抑制剂引起2型糖尿病患者上呼吸道感染的网状Meta分析

Network Meta Analysis of Upper Respiratory Tract Infection in Type 2 Diabetes Patients Induced by SGLT-2 Inhibitors

目的:采用网状Meta分析的方法对不同SGLT-2(钠-葡萄糖共转运蛋白-2)抑制剂引起2型糖尿病患者上呼吸道感染风险的相关性进行系统评价。方法:检索相关中英文数据库,获取不同SGLT-2抑制剂治疗2型糖尿病患者的随机对照试验,检索时间从建库至2023年2月。按照纳入和排除标准筛选文献、提取数据并对纳入的研究进行方法学质量评价,使用Stata 15.1软件进行网状Meta分析。结果:最终纳入12篇文献,共5615例患者。网状Meta分析结果显示,卡格列净300 mg与恩格列净10 mg(RR=1.74,95%CI=1.05,5.75)及安慰剂(RR=1.10,95%CI=1.06,4.83)相比,发生上呼吸道感染的风险增高,其他不同剂量的SGLT-2抑制剂之间相比较差异无统计学意义;网状Meta分析排序结果显示,SGLT-2抑制剂治疗2型糖尿病时不容易引起上呼吸道感染事件发生的排序结果为卡格列净50 mg>恩格列净10 mg>达格列净1 mg>埃格列净1 mg>埃格列净5 mg>达格列净2.5 mg>达格列净5 mg>卡格列净100 mg>埃格列净10 mg>埃格列净25 mg>安慰剂>恩格列净25 mg>达格列净10 mg>卡格列净200 mg>卡格列净300 mg。结论:SGLT-2抑制剂治疗2型糖尿病时卡格列净50 mg的上呼吸感染发生率最低,卡格列净300 mg发生率最高。

Objective:To systematically evaluate the correlation between the risk of upper respiratory tract infection caused by different SGLT-2(sodium glucose cotransporter-2)inhibitors in patients with type 2 diabetes by using a mesh meta-analysis method.Methods:The relevant Chinese and English databases were searched to obtain the randomized controlled trials of different SGLT-2 inhibitors in the treatment of type 2 diabetes patients.The search time was from the establishment of the database to February 2023.According to the inclusion and exclusion criteria,literature was screened,data was extracted,and methodological quality evaluation was conducted on the included studies.A mesh meta-analysis was conducted using Stata 15.1 software.Results:12 articles were ultimately included,with a total of 5615 patients.The results of the mesh meta-analysis showed that compared with Engliflozin 10 mg(RR=1.74,95%CI=1.05,5.75)and placebo(RR=1.10,95%CI=1.06,4.83),Cargliflozin 300mg had an increased risk of upper respiratory tract infection.There was no statistically significant difference between other different doses of SGLT-2 inhibitors;The sorting result of network meta-analysis showed that it was not easy to cause upper respiratory tract infection events when SGLT-2 inhibitors were used to treat type 2 diabetes.The sorting result was cagelin 50 mg>enggligin 10 mg>daggligin 1 mg>eggligin 1 mg>eggligin 5 mg>daggligin 2.5 mg>daggligin 5 mg>caggligin 100 mg>eggligin 10 mg>eggligin 25 mg>placebo>enggligin 25 mg>daggligin 10 mg>caggligin 200 mg>caggligin 300 mg.Conclusion:When SGLT-2 inhibitor is used to treat type 2 diabetes,the incidence of respiratory infection is the lowest when 50 mg of kagliflozin is used,and the highest when 300 mg of kagliflozin is used.