Fan Minhua, Li Yuelan, Zhang Shihong
From the Department of Nursing, Liaocheng People's Hospital, Liaocheng, Shandong, PR China.
Medicine (Baltimore). 2016 Jan;95(2):e2386. doi: 10.1097/MD.0000000000002386.
Sitagliptin has been reported to improve lipid profiles, but findings from these studies are conflicting. We conducted this meta-analysis to evaluate the effects of sitagliptin on serum lipids in patients with type 2 diabetes mellitus.We made a comprehensive literature search in PubMed, EMBASE, Cochrane Library, China National Knowledge Infrastructure, Wanfang, and VIP database until June 2015. Eligible studies were randomized clinical trials (RCTs) that investigated the effect of sitagliptin on serum triglycerides (TGs), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), or high-density lipoprotein cholesterol (HDL-C).Eleven RCTs with 2338 patients were identified. Compared with controls, sitagliptin alone or in combination significantly improved serum TG (weighted mean difference [WMD] -0.24 mmol/L; 95% confidence interval [CI] -0.40 to -0.09; P = 0.002) and HDL-C (WMD 0.05 mmol/L; 95% CI 0.02-0.07; P < 0.001).However, no statistical significances were observed in LDL-C (WMD -0.07 mmol/L; 95% CI -0.22 to 0.08; P = 0.337) and TC (WMD -0.14; 95% CI -0.33 to 0.06; P = 0.177). Subgroup analyses revealed that sitagliptin alone achieved greater improvement in serum TG, TC, and HDL-C levels.These findings suggested that sitagliptin alone or in combination significantly improved serum TG and HDL-C levels in patients with type 2 diabetes mellitus.
据报道，西他列汀可改善血脂水平，但这些研究的结果相互矛盾。我们进行了这项荟萃分析，以评估西他列汀对2型糖尿病患者血脂的影响。我们在PubMed、EMBASE、Cochrane图书馆、中国知网、万方和维普数据库中进行了全面的文献检索，检索截至2015年6月。符合条件的研究为随机临床试验（RCT），研究西他列汀对血清甘油三酯（TG）、总胆固醇（TC）、低密度脂蛋白胆固醇（LDL-C）或高密度脂蛋白胆固醇（HDL-C）的影响。共纳入11项RCT，涉及2338例患者。与对照组相比，单独使用或联合使用西他列汀可显著改善血清TG（加权平均差[WMD] -0.24 mmol/L；95%置信区间[CI] -0.40至-0.09；P = 0.002）和HDL-C（WMD 0.05 mmol/L；95% CI 0.02 - 0.07；P < 0.001）。然而，在LDL-C（WMD -0.07 mmol/L；95% CI -0.22至0.08；P = 0.337）和TC（WMD -0.14；95% CI -0.33至0.06；P = 0.177）方面未观察到统计学显著性。亚组分析显示，单独使用西他列汀可使血清TG、TC和HDL-C水平有更大改善。这些发现表明，单独使用或联合使用西他列汀可显著改善2型糖尿病患者的血清TG和HDL-C水平。
