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利拉鲁肽治疗2型糖尿病的系统评价

颜新, 邓宏明, 肖常青

颜新, 邓宏明, 肖常青. 利拉鲁肽治疗2型糖尿病的系统评价[J]. 循证医学, 2012, 12(2): 117-124. DOI: 10.3969/j.issn.1671-5144.2012.02.018
引用本文: 颜新, 邓宏明, 肖常青. 利拉鲁肽治疗2型糖尿病的系统评价[J]. 循证医学, 2012, 12(2): 117-124. DOI: 10.3969/j.issn.1671-5144.2012.02.018
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YAN Xin, DENG Hong-ming, XIAO Chang-qing. Systematic Review of GLP-1 Analogues—Liraglutide for Type 2 Diabetes Mellitus[J]. Journal of Evidence-Based Medicine, 2012, 12(2): 117-124. DOI: 10.3969/j.issn.1671-5144.2012.02.018
Citation: YAN Xin, DENG Hong-ming, XIAO Chang-qing. Systematic Review of GLP-1 Analogues—Liraglutide for Type 2 Diabetes Mellitus[J]. Journal of Evidence-Based Medicine, 2012, 12(2): 117-124. DOI: 10.3969/j.issn.1671-5144.2012.02.018
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利拉鲁肽治疗2型糖尿病的系统评价

  • 广西医科大学第一附属医院代谢糖尿病中心, 南宁 530021

详细信息
    作者简介:

    颜新（1977-）,男,广西北流人,硕士研究生,从事糖尿病防治研究,现在广西医科大学第三附属医院南宁市第二人民医院工作。

    通讯作者:

    肖常青,Tel: 0771-3277199, E-mail: chqxiao@263.net

  • 中图分类号: R587.105

Systematic Review of GLP-1 Analogues—Liraglutide for Type 2 Diabetes Mellitus

  • Metabolic Diabetes Center, The First Affiliated Hospital, Guangxi MedicaI University, Nanning 530021, China

摘要

    摘要
  • 摘要: 目的 评价类胰高血糖素样肽-1类似物——利拉鲁肽治疗2型糖尿病的疗效与安全性。 方法 应用Cochrane 系统评价方法,对Cochrane图书馆的Cochrane对照试验注册数据库、PubMed、EMBASE、The National Reseach Register、 Current Controlled Trials、中国生物医学文献数据库、中国期刊全文数据库、VIP,建库至2011年8月6日间的所有文献进行检索,查找符合纳入标准的随机对照试验进行质量评价,运用RevMan 5.0统计软件对提取的相关数据进行Meta分析。 结果 最终纳入8个随机对照试验,共计3 351例患者,并对其疗效和安全性进行了Meta分析,表明利拉鲁肽与对照组相比,能更有效降低糖化血红蛋白[标准化均数差=-5.34,95%可信区间（-6.92,-3.75）,P<0.000 01]和空腹血糖[标准化均数差=-0.80,95%可信区间（-0.94,-0.66）,P<0.000 01],能减轻体重[标准化均数差=-0.37,95%可信区间（-0.51,-0.22）,P<0.000 01],低血糖风险相似[相对危险度=1.2, 95%可信区间（0.55,2.62）,P=0.64];利拉鲁肽胃肠道反应更常见,但短暂而轻微。 结论 利拉鲁肽作为一种新的肠促胰岛激素类似物,能显著控制血糖、减轻体重,与对照组低血糖风险相似。但其胃肠道反应较常见,程度较轻而短暂。它为2型糖尿病患者提供了一种新的降糖药选择。
    Abstract: Objective To assess the efficacy and safety of GLP-1 analogues — Liraglutide for T2DM. Methods Based on the principles and methods of Cochrane systematic reviews, electronic database searching was performed on search The Cochrane Library, PubMed, EMBASE, The National Research Register, Current Controlled Trials, CBM, CNKI, VIP, and the data from the beginning of the database to June 8th, 2011 were included. Randomized controlled trials（RCT） concerning Liraglutide for T2DM were selected and assessed for the methodological quality, and the extracted data were performed meta-anlysis by statistical software RevMan 5.0. Result Eight RCTs involving 3 351 patients met the inclusion criteria. Compared with control, Liraglutide showed significant positive effects on lowering hemoglobin A1c,FPG. The effect sizes were [SMD=-5.34,95%CI（-6.92,-3.75）, P<0.000 01] and [SMD=-0.80,95%CI（-0.94, -0.66）, P<0.000 01] respectively. Liraglutide resulted in weight loss[SMD=-0.37, 95%CI（-0.51,-0.22）,P<0.000 01]. For side effects Liraglutide had a similar risk of hypoglycemia with control [RR=1.2, 95%CI （0.55,2.62）, P=0.64]. Adverse effects（AEs） were reported in included studies, the most of which were gastrointestinal reaction. And these events were mostly slight and transient. It suggested that Liraglutide was safe. Conclusions As a new incretin analogues,Liraglutide is more effective in lowering blood glucose than control. Furthermore, it resulted in weight loss and had similar risk of hypoglycemia. However its gastrointestinal reactions are more common than control which are mostly slight and transient. It offers an alternative option to currently available hypoglycemic agents for patients with T2DM.
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    • 参考文献(15)
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出版历程
  • 收稿日期:  2011-08-30
  • 发布日期:  2012-04-27

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