Cardiovascular outcomes of antidiabetes medications by race/ethnicity: A systematic review and meta-analysis.
Cardiovascular outcomes of antidiabetes medications by race/ethnicity: A systematic review and meta-analysis.
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DOI：
10.1016/j.jdiacomp.2021.107980
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发表时间：
2021-09
影响因子：
3
通讯作者：
Ji L
中科院分区：
文献类型：
--
作者：
Cai X;Lin C;Yang W;Dagogo-Jack S;Ji L
抗糖尿病药物在不同种族和族裔群体中降低心血管风险的一致性仍不明确。本研究的目的是分析2型糖尿病患者中抗糖尿病药物心血管结局试验结果的种族/族裔模式。
从起始日期到2020年12月对PubMed和Cochrane图书馆数据库进行了检索。纳入了将2型糖尿病患者随机分配接受抗糖尿病药物或对照治疗，并按种族/族裔群体或地区报告结果的心血管结局试验。
这项荟萃分析共纳入了16项研究。在白人参与者中，与安慰剂治疗相比，抗糖尿病药物治疗显著降低了复合心血管结局的风险（优势比=0.90，95%置信区间0.86 - 0.94，p<0.05）。在亚洲参与者中，与对照治疗相比，抗糖尿病药物也显著降低了复合心血管结局的风险（优势比=0.82，95%置信区间0.76 - 0.90，p<0.05）。然而，在黑人参与者（优势比=0.96，95%置信区间0.69 - 1.32，p = 0.79）和其他群体（主要是西班牙裔或太平洋岛民）的受试者（优势比=0.92，95%置信区间0.81 - 1.04，p = 0.16）中，与对照治疗相比，抗糖尿病药物治疗导致复合心血管结局有轻微但不显著的降低。
本项荟萃分析显示，在所研究的所有种族/族裔的2型糖尿病患者中，抗糖尿病药物具有心血管安全性；然而，仅在白人和亚洲参与者中证明了复合心血管风险的显著降低。要确定抗糖尿病药物是否在黑人和其他种族/族裔参与者中带来一致的心血管益处，未来还需要更多的研究。
The consistency of cardiovascular risk reduction by antidiabetes medications across racial and ethnic groups remains unclear. The aim of this study was to analyze racial/ethnic patterns in the results of cardiovascular outcomes trials of antidiabetes medications in people with type 2 diabetes. PubMed and Cochrane library databases were searched from the inception dates to December 2020. Cardiovascular outcome trials in type 2 diabetes that randomized participants to antidiabetes medication or control treatment and reported results by race/ethnic groups or region were included. A total of 16 studies were included in this meta-analysis. Among White participants, treatment with antidiabetes medications significantly decreased the risk of composite cardiovascular outcomes (OR=0.90, 95% CI 0.86–0.94, p<0.05) when compared with placebo treatment. Among Asian participants, antidiabetes medications also significantly decreased the risk of composite cardiovascular outcomes when compared with control treatment (OR=0.82, 95%CI 0.76–0.90, p<0.05). However, among Black participants (OR=0.96, 95% CI 0.69–1.32, p=0.79) and subjects from other groups (mostly Hispanics or Pacific Islanders) (OR=0.92, 95% CI 0.81–1.04, p=0.16), treatment with antidiabetes medications resulted in nominal but non-significant decreases in the composite cardiovascular outcomes when compared with control treatment. The present meta-analysis showed cardiovascular safety of antidiabetes medications in people with type 2 diabetes from all racial/ethnic groups studied; however, significant composite cardiovascular risk reductions were demonstrated only in White and Asian participants. To determine whether antidiabetes drugs confer consistent cardiovascular benefits in Black and other racial/ethnic participants requires more investigations in the future.
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