Mahmoud Ahmed N, Elgendy Islam Y, Saad Marwan, Elgendy Akram Y, Barakat Amr F, Mentias Amgad, Abuzaid Ahmed, Bavry Anthony A
Department of Medicine, University of Florida, Gainesville, FL, USA.
Department of Medicine, University of Arkansas for Medical Sciences, Little Rock, AR, USA.
Cardiol Ther. 2017 Jun;6(1):129-132. doi: 10.1007/s40119-016-0075-1. Epub 2016 Nov 28.
Although a large recent trial had shown improved cardiovascular outcomes of diabetic patients on sodium glucose co-transporter-2 (SGLT-2) inhibitors, the influence of gender differences on such outcomes is not known. Thus, we aimed to assess the impact of gender on such outcomes in the patients with type 2 diabetes mellitus receiving SGLT-2 inhibitors.
A search of electronic databases was conducted for all randomized trials comparing SGLT-2 inhibitors with placebo in patients with diabetes mellitus. Primary outcomes were all-cause mortality and cardiovascular mortality. Random effects meta-regression was conducted using the percentage of women included in the SGLT-2 inhibitor arm of each trial with a P value of <0.1 for statistical significance.
A total of 22,256 patients from 26 trials were included. The overall odds ratio (OR) of all-cause mortality [OR = 0.72, 95% confidence interval (CI) 0.60-0.86, P < 0.001, I = 0%], and cardiovascular mortality (OR = 0.67, 95% CI 0.53-0.84, P = 0.001, I = 23%) were lower with SGLT-2 inhibitors. Meta-regression suggested a possible incremental increase in the OR for all-cause mortality and cardiovascular mortality as the percentage of women in the SGLT-2 inhibitor arm increased (P = 0.07 and 0.08, respectively).
Gender might influence the cardiovascular benefits observed with SGLT-2 inhibitors in patients with type 2 diabetes mellitus.
尽管最近一项大型试验表明，使用钠-葡萄糖协同转运蛋白2（SGLT-2）抑制剂的糖尿病患者心血管结局有所改善，但性别差异对这些结局的影响尚不清楚。因此，我们旨在评估性别对接受SGLT-2抑制剂的2型糖尿病患者这些结局的影响。
检索电子数据库，查找所有比较SGLT-2抑制剂与安慰剂治疗糖尿病患者的随机试验。主要结局为全因死亡率和心血管死亡率。采用随机效应Meta回归分析，以各试验SGLT-2抑制剂组中女性所占百分比为自变量，P值<0.1具有统计学意义。
共纳入26项试验的22256例患者。SGLT-2抑制剂组全因死亡率[比值比（OR）=0.72，95%置信区间（CI）0.60-0.86，P<0.001，I²=0%]和心血管死亡率（OR=0.67，95%CI 0.53-0.84，P=0.001，I²=23%）较低。Meta回归分析表明，随着SGLT-2抑制剂组中女性百分比增加，全因死亡率和心血管死亡率的OR可能会逐渐升高（分别为P=0.07和0.08）。
性别可能会影响2型糖尿病患者使用SGLT-2抑制剂所观察到的心血管获益。
