Use of glucagon-like peptide-1 receptor agonists and bone fractures: A meta-analysis of randomized clinical trials
Use of glucagon-like peptide-1 receptor agonists and bone fractures: A meta-analysis of randomized clinical trials
复制标题
DOI：
10.1111/1753-0407.12102
复制
发表时间：
2014-05-01
影响因子：
4.5
通讯作者：
Chappard, Daniel
中科院分区：
文献类型：
--
作者：
Mabilleau, Guillaume;Mieczkowska, Aleksandra;Chappard, Daniel
背景2型糖尿病（T2 DM）患者骨折的风险较高，与抗糖尿病药物的使用无关。此外，抗糖尿病药物可直接影响骨代谢。最近，二肽基肽酶-4抑制剂的使用与较低的骨折率有关。本荟萃分析的目的是评估使用胰高血糖素样肽-1受体激动剂（GLP-1 Ra）治疗的T2 DM患者与使用其他抗糖尿病药物的患者相比骨折发生率是否较低。以及手动检索使用GLP-1治疗T2 DM的随机临床试验，1 Ra或另一种降糖药物的持续时间为24周进行了由两名作者（GM，AM）independently.ResultsAlthough 28个合格的研究确定，只有7项试验报告的发生至少骨折的一个手臂的试验。骨折总数为19例（GLP-1 Ra组13例，对照组6例）。GLP-1 Ra的合并Mantel-Haenszel比值比为0.75（95%置信区间0.28-2.02，P=0.569），在试验中与其他抗糖尿病药物相比。2？4？Meta？1？（胰高血糖素样肽-1受体激动剂，GLP-1 Ra）？2？(GM，AM）？Medline？Embase？GLP-1Ra？24岁？2？28岁？7？十九岁？（GLP-1Ra）13岁？6？）？，？？，GLP-1Ra？曼特尔-亨泽尔？？？？0.75（95%）0.28- 2.02，P = 0.569），均数均GLP-1Ra？2型糖尿病？
BackgroundPatients with type 2 diabetes mellitus (T2DM) are at a higher risk of bone fractures independent of the use of antidiabetic medications. Furthermore, antidiabetic medications could directly affect bone metabolism. Recently, the use of dipeptidyl peptidase-4 inhibitors has been associated with a lower rate of bone fracture. The aim of the present meta-analysis was to assess whether patients with T2DM treated with glucagon-like peptide-1 receptor agonists (GLP-1Ra) present a lower incidence of bone fracture compared with patients using other antidiabetic drugs.MethodsA search on Medline, Embase, and , as well as a manual search for randomized clinical trials of T2DM treated with either a GLP-1Ra or another antidiabetic drug for a duration of 24 weeks was conducted by two authors (GM, AM) independently.ResultsAlthough 28 eligible studies were identified, only seven trials reported the occurrence of at least a bone fracture in one arm of the trial. The total number of fractures was 19 (13 and six with GLP-1Ra and comparator, respectively). The pooled Mantel-Haenszel odds ratio for GLP-1Ra was 0.75 (95% confidence interval 0.28-2.02, P=0.569) in trials versus other antidiabetic agents.ConclusionsAlthough preliminary, our study highlighted that the use of GLP-1Ra does not modify the risk of bone fracture in T2DM compared with the use of other antidiabetic medications.????2?????????????,?????????????,?????????????????,??????????-4???????????????meta????????????????????,???????????-1?????(glucagon-like peptide-1 receptor agonists, GLP-1Ra)???2???????????????????????????(GM,AM)????Medline?Embase???????????????GLP-1Ra???????????? 24??2???????????????????28??????,????7????????????????????????????????19?(GLP-1Ra????????13??6?)??????,??????????,GLP-1Ra??????Mantel-Haenszel????0.75(95%?????0.28-2.02,P = 0.569)??????????????,?????????????????????????,??GLP-1Ra????T2DM????????