利拉鲁肽联合阿卡波糖治疗肥胖2型糖尿病有效性和安全性的Meta分析

The efficacy and safety of liraglutide combined with acarbose in the treatment of obese type 2 diabetes mellitus:a meta-analysis

目的 运用Meta分析的方法评价利拉鲁肽联合阿卡波糖治疗肥胖2型糖尿病有效性和安全性。方法 计算机全面检索中国生物医学文献数据库(CBM)、中国知网(CNKI)、万方数据库、中文科技期刊数据库(VIP)、PubMed、Embase、The Cochrane Library和Web of Science,搜集关于利拉鲁肽联合阿卡波糖治疗与单一采用阿卡波糖治疗肥胖2型糖尿病比较的随机对照试验(RCT)。运用RevMan 5.3软件进行Meta分析,以相对危险度(RR)作为二分类数据的效应量,以均数差(MD)作为连续型数据的效应量。结果 共纳入14个RCT,包含1 416例患者,其中利拉鲁肽联合阿卡波糖组709例,单一采用阿卡波糖组707例。结果显示,利拉鲁肽联合阿卡波糖组与单一阿卡波糖治疗比较,在降低空腹血糖、餐后2 h血糖、体重指数、总胆固醇、甘油三酯、糖化血红蛋白、胰岛素抵抗指数方面差异有统计学意义(P <0.05);两组低血糖的发生率、消化系统不良反应发生率差异无统计学意义(P> 0.05)。结论利拉鲁肽联合阿卡波糖治疗肥胖2型糖尿病在降低空腹血糖、餐后2 h血糖、体重指数、总胆固醇、甘油三酯、糖化血红蛋白、胰岛素抵抗指数等方面优于单一使用阿卡波糖,且不增加低血糖及消化系统不良反应发生率。

Objective To evaluate the efficacy and safety of liraglutide combined with acarbose in the treatment of obese type 2 diabetes mellitus by Meta-analysis.Methods A comprehensive computerized search of the China Biomedical Literature Database(CBM),China Knowledge Internet(CNKI),Wanfang Database,Chinese Science and Technology Journal Database(VIP),PubMed,Embase,The Cochrane Library,and Web of Science https://zgys.whuznhmedj.com was conducted to collect data on the use of liraglutide in combination with acarbose for the treatment of obesity type 2 diabetes mellitus compared with the use of acarbose alone.Randomized controlled trials(RCTs)comparing treatment of obese type 2 diabetes.Meta-analysis was performed using RevMan 5.3 software,with relative risk ratio(RR)as the effect size for dichotomous data and mean difference(MD)as the effect size for continuous data.Results A total of 14 RCTs containing 1,416 patients were included,including 709 in the liraglutide combined with acarbose group and 707 in the acarbose alone group.The results showed that the difference between the liraglutide combined with acarbose group and single acarbose treatment was statistically significant in reducing fasting glucose,2 h postprandial glucose,body mass index,total cholesterol,triglycerides,glycosylated hemoglobin,and insulin resistance index(P<0.05);and there was no statistically significant difference in the incidence of hypoglycemia and the incidence of gastrointestinal system adverse reactions between the two groups(P>0.05).Conclusion Liraglutide combined with acarbose in the treatment of obese type 2 diabetes mellitus is superior to the single use of acarbose in lowering fasting glucose,postprandial 2h glucose,body mass index,total cholesterol,triglyceride,glycosylated hemoglobin,and insulin resistance index,and does not increase the incidence of hypoglycemia and digestive system adverse reactions.