[目的]探讨二肽基肽酶4抑制剂(DPP-4i)对2型糖尿病(T2DM)患者血清肌酐(Cr)的影响。[方法]系统检索PubMed、Embase、Cochrane Library和Web of Science数据库,纳入DPP-4i治疗T2DM患者调节Cr的随机对照试验(RCT)。采用固定效应或随机效应...[目的]探讨二肽基肽酶4抑制剂(DPP-4i)对2型糖尿病(T2DM)患者血清肌酐(Cr)的影响。[方法]系统检索PubMed、Embase、Cochrane Library和Web of Science数据库,纳入DPP-4i治疗T2DM患者调节Cr的随机对照试验(RCT)。采用固定效应或随机效应模型进行数据拟合,采用I^(2)指数定量评价异质性,使用标准方法进行敏感性分析和发表偏倚检验。[结果]经系统检索数据库,纳入12项RCT,共计2276名受试者。由于潜在异质性的原因,故采用随机效应模型进行数据拟合,DPP-4i治疗可轻度提高T2DM患者的Cr水平(WMD:0.15 mg/L,95%CI:0.03~0.27,I^(2)=18%,P=0.02),结果具有统计学差异。根据敏感性测试,Meta分析其结果较为可靠。同时进行Begg’s与Egger’s检验,未见发表偏倚。[结论]T2DM患者应用DPP-4i进行降糖治疗,可能会出现血Cr水平轻度升高。未来还需开展更大样本量的多中心研究,以进一步探讨DPP-4i治疗引起Cr水平改变的临床意义。展开更多
心脏重塑是心脏在持续性压力、代谢等刺激下发生的适应性形态结构变化过程,其中病理性心脏重塑是心血管不良事件独立危险因素。新型降糖药物钠–葡萄糖协同转运蛋白-2 (sodium-glucose cotransporter 2, SGLT2)抑制剂除了能够降低容量...心脏重塑是心脏在持续性压力、代谢等刺激下发生的适应性形态结构变化过程,其中病理性心脏重塑是心血管不良事件独立危险因素。新型降糖药物钠–葡萄糖协同转运蛋白-2 (sodium-glucose cotransporter 2, SGLT2)抑制剂除了能够降低容量负荷、减少心血管死亡及住院风险外,还展现出改善心脏结构和功能、逆转心脏重构的潜力。本文旨在对SGLT2抑制剂在改善心脏重塑方面的研究进展进行综述。Cardiac remodeling, a process of adaptive morphological and structural alterations in the heart triggered by sustained stress, metabolic, and other stimuli, among which pathological cardiac remodeling serves as an independent predictor of adverse cardiovascular outcomes. Recently, novel hypoglycemic agents, specifically sodium-glucose cotransporter 2 (SGLT2) inhibitors, have emerged as potential therapeutics that not only alleviate volume overload but also reduce the risk of cardiovascular mortality and hospitalization. Additionally, these agents exhibit promising effects in improving cardiac structure and function, as well as reversing pathological cardiac remodeling. This article aims to comprehensively review the progress made in investigating the therapeutic benefits of SGLT2 inhibitors in ameliorating cardiac remodeling.展开更多
文摘[目的]探讨二肽基肽酶4抑制剂(DPP-4i)对2型糖尿病(T2DM)患者血清肌酐(Cr)的影响。[方法]系统检索PubMed、Embase、Cochrane Library和Web of Science数据库,纳入DPP-4i治疗T2DM患者调节Cr的随机对照试验(RCT)。采用固定效应或随机效应模型进行数据拟合,采用I^(2)指数定量评价异质性,使用标准方法进行敏感性分析和发表偏倚检验。[结果]经系统检索数据库,纳入12项RCT,共计2276名受试者。由于潜在异质性的原因,故采用随机效应模型进行数据拟合,DPP-4i治疗可轻度提高T2DM患者的Cr水平(WMD:0.15 mg/L,95%CI:0.03~0.27,I^(2)=18%,P=0.02),结果具有统计学差异。根据敏感性测试,Meta分析其结果较为可靠。同时进行Begg’s与Egger’s检验,未见发表偏倚。[结论]T2DM患者应用DPP-4i进行降糖治疗,可能会出现血Cr水平轻度升高。未来还需开展更大样本量的多中心研究,以进一步探讨DPP-4i治疗引起Cr水平改变的临床意义。
文摘心脏重塑是心脏在持续性压力、代谢等刺激下发生的适应性形态结构变化过程,其中病理性心脏重塑是心血管不良事件独立危险因素。新型降糖药物钠–葡萄糖协同转运蛋白-2 (sodium-glucose cotransporter 2, SGLT2)抑制剂除了能够降低容量负荷、减少心血管死亡及住院风险外,还展现出改善心脏结构和功能、逆转心脏重构的潜力。本文旨在对SGLT2抑制剂在改善心脏重塑方面的研究进展进行综述。Cardiac remodeling, a process of adaptive morphological and structural alterations in the heart triggered by sustained stress, metabolic, and other stimuli, among which pathological cardiac remodeling serves as an independent predictor of adverse cardiovascular outcomes. Recently, novel hypoglycemic agents, specifically sodium-glucose cotransporter 2 (SGLT2) inhibitors, have emerged as potential therapeutics that not only alleviate volume overload but also reduce the risk of cardiovascular mortality and hospitalization. Additionally, these agents exhibit promising effects in improving cardiac structure and function, as well as reversing pathological cardiac remodeling. This article aims to comprehensively review the progress made in investigating the therapeutic benefits of SGLT2 inhibitors in ameliorating cardiac remodeling.
