Effect of GLP-1 receptor agonists on waist circumference among type 2 diabetes patients: a systematic review and network meta-analysis
Effect of GLP-1 receptor agonists on waist circumference among type 2 diabetes patients: a systematic review and network meta-analysis
复制标题
GLP-1受体激动剂对2型糖尿病患者腰围的影响：系统评价和网络荟萃分析
DOI：
10.1007/s12020-014-0373-0
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发表时间：
2015-04-01
期刊：
影响因子：
3.7
通讯作者：
Zhan, Siyan
中科院分区：
文献类型：
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作者：
Sun, Feng;Wu, Shanshan;Zhan, Siyan
胰升糖素样肽-1受体激动剂(GLP-1RAs)越来越多地用于2型糖尿病患者。然而，对腹型肥胖症的影响尚未得到证实。本研究旨在系统评价GLP-1RAs对2型糖尿病患者腰围的影响。通过检索Medline、EMBASE、Cochrane图书馆和www.Clinicaltrialgov，检索至2013年10月31日。如果他们将GLP-1 RAS与安慰剂和传统抗糖尿病药物进行比较，则选择了具有可用数据的随机对照试验，持续时间≥为8周。采用随机效应模型估计加权平均差值。网络荟萃分析是对直接比较的补充。共纳入17个试验，12个处理。总体而言，与安慰剂相比，每天一次服用利拉鲁肽-1.8亿毫克(−5.24厘米，95%CI−7.68，−2.93)、每天一次利拉鲁肽-1.2毫克(−4.73厘米，95%CI−6.68，−2.65)和每天两次埃塞那肽-10μg(−1.34厘米，95%CI−2.00，−0.75)后，腰围显著减少。与胰岛素和噻唑烷二酮(−1.71~−8.03 cm)相比，降糖效果更明显。与艾塞那肽相比，利拉鲁肽每日1次、他泊洛肽、利拉鲁肽每天1次、利拉鲁肽每天1次，腰围由−3.32降至−6.01 cm。此外，与西格列汀相比，每天一次的利拉鲁肽-1.80 mg显著减少了−1.73 cm(95%CI−3.04，−0.55)，而每天一次的利拉鲁肽与每天一次的利拉鲁肽-1.8 mg和西格列汀相比没有显著差异。艾塞那肽-10μg每日2次与艾塞那肽-5μg每日2次相比减少有统计学意义(−1.21 cm，95%CI−2.43，−0.06)。排序概率分析表明，在所有12个治疗方案中，利拉鲁肽1.8 mg/d和利拉鲁肽1.2 mg/d减少腰围的概率最大，概率分别为98.36%和91.82%。一些GLP-1RAs，特别是每天一次的利拉鲁肽-1.8毫克和每天一次的利拉鲁肽-1.2毫克，与腰围的显著减少有关。
Glucagon-like peptide-1 receptor agonists (GLP-1RAs) are increasingly used in patients with type 2 diabetes. However, the effect on abdominal obesity has not yet been confirmed. The study aimed to systematically evaluate the effect of GLP-1RAs on waist circumference in patients with type 2 diabetes. MEDLINE, EMBASE, the Cochrane library and www.clinicaltrialgov were searched through October 31, 2013. Randomized controlled trials with available data were selected if they compared GLP-1 RAs with placebo and traditional anti-diabetic drugs with a duration ≥8 weeks. Weighted mean difference was estimated using random-effect model. Network meta-analysis was performed to supplement direct comparisons. Seventeen trials with 12 treatments were included. Overall, significant reductions on waist circumference following treatment of liraglutide—1.8 mg once daily (−5.24 cm, 95 % CI −7.68, −2.93), liraglutide—1.2 mg once daily (−4.73 cm, 95 % CI −6.68, −2.65) and exenatide—10 μg twice daily (−1.34 cm, 95 % CI −2.00, −0.75) were detected versus placebo. The reduction effect was more evident when compared with insulin and thiazolidinediones (range −1.71 to −8.03 cm). Compared with exenatide, liraglutide—0.6 mg once daily, taspoglutide, liraglutide—1.2 mg once daily and liraglutide—1.8 mg once daily significantly decreased waist circumference from −3.32 to −6.01 cm. Besides, liraglutide—1.8 mg once daily significantly decreased waist circumference by −1.73 cm (95 % CI −3.04, −0.55) versus sitagliptin, whereas no significant difference following liraglutide—1.2-mg-once-daily treatment was detected compared with liraglutide—1.8 mg once daily and sitagliptin. Reduction was observed with statistical significance for exenatide—10 μg twice daily compared with exenatide—5 μg twice daily (−1.21 cm, 95 % CI −2.43, −0.06). Ranking probability analysis indicated liraglutide—1.8 mg once daily and liraglutide—1.2 mg once daily decreased waist circumference most among all 12 treatments with probability of 98.36% and 91.82 %, respectively. Some GLP-1RAs, especially liraglutide—1.8 mg once daily and liraglutide—1.2 mg once daily, were associated with a significant reduction in waist circumference.