胆汁酸螯合剂对血脂和血糖浓度的影响：一项随机对照试验的系统评价和荟萃分析。

The effects of bile acid sequestrants on lipid profile and blood glucose concentrations: A systematic review and meta-analysis of randomized controlled trials.

作者信息

Mazidi Mohsen, Rezaie Peyman, Karimi Ehsan, Kengne Andre Pascal

机构信息

Key State Laboratory of Molecular Developmental Biology, Institute of Genetics and Developmental Biology, Chinese Academy of Sciences, Chaoyang, Beijing, China; Institute of Genetics and Developmental Biology, International College, University of Chinese Academy of Science (IC-UCAS), West Beichen Road, Chaoyang, China.

Biochemistry and Nutrition Research Center, School of Medicine, Mashhad University of Medical Science, Mashhad, Iran.

出版信息

Int J Cardiol. 2017 Jan 15;227:850-857. doi: 10.1016/j.ijcard.2016.10.011. Epub 2016 Oct 11.

DOI:10.1016/j.ijcard.2016.10.011

PMID:28029410

Abstract

AIM

To undertake a systematic review and meta-analysis of prospective clinical studies to determine the effect of bile acid sequestrants (BAS) on lipid profile and blood glucose concentrations.

METHOD

PubMed-Medline, Web of Science, Cochrane Database and Google Scholar databases were searched (up until August 2016) to identify prospective studies evaluating the impact of BASs on the cardio-metabolic profile. Random effects model meta-analysis was used for quantitative data synthesis. Sensitivity analysis was conducted using the leave-one-out method. Heterogeneity was quantitatively assessed using the I index. Systematic review registration: CRD42016035973.

RESULTS

From a total of 769 entries identified, 15 studies were included in the final analysis. The meta-analysis indicated a significant reduction in fasting serum triglyceride concentrations following treatment with BASs (weighted mean difference [WMD] 0.54mg/dL, 95% CI 0.43 to 0.65, heterogeneity p=0.021; I 54.2%, n=11 studies). The WMDs for total serum cholesterol (TC) was -1.18mg/dL (95% CI -1.30 to -1.06, heterogeneity p=0012; I 63.1%, n=11 studies), 0.126mg/dL (95% CI 0.02 to 0.22, heterogeneity p=0.231; I 43.2%, n=11 studies) for HDL-cholesterol, and -0.24mg/dL (95% CI -0.35 to -0.14, heterogeneity p=0.562; I 23.1%, n=10 studies) for LDL-cholesterol, and -2.10mg/dL (95% CI -2.84 to -1.36, heterogeneity p=0.200; I 42.6%, n=11 studies) fasting blood glucose (FBG) and -0.83% (95% CI -1.08 to -0.57, heterogeneity p=0.856; I 20.9%, n=11 studies) for HbA1c. These findings were robust in sensitivity analyses.

CONCLUSIONS

This meta-analysis suggests that therapy with BAS significantly improves HDL-C, LDL-C, and glycemic markers including fasting blood glucose, HbA1c levels, while deteriorating triglyceride levels.

摘要

目的

对前瞻性临床研究进行系统评价和荟萃分析，以确定胆汁酸螯合剂（BAS）对血脂谱和血糖浓度的影响。

方法

检索PubMed-Medline、Web of Science、Cochrane数据库和谷歌学术数据库（截至2016年8月），以识别评估BAS对心脏代谢谱影响的前瞻性研究。采用随机效应模型荟萃分析进行定量数据合成。使用逐一剔除法进行敏感性分析。使用I指数对异质性进行定量评估。系统评价注册号：CRD42016035973。

结果

在总共识别出的769条记录中，15项研究纳入最终分析。荟萃分析表明，使用BAS治疗后空腹血清甘油三酯浓度显著降低（加权平均差[WMD]0.54mg/dL，95%置信区间0.43至0.65，异质性p=0.021；I² 54.2%，n=11项研究）。总血清胆固醇（TC）的WMD为-1.18mg/dL（95%置信区间-1.30至-1.06，异质性p=0.012；I² 63.1%，n=11项研究），高密度脂蛋白胆固醇（HDL-C）为0.126mg/dL（95%置信区间0.02至0.22，异质性p=0.231；I² 43.2%，n=11项研究），低密度脂蛋白胆固醇（LDL-C）为-0.24mg/dL（95%置信区间-0.35至-0.14，异质性p=0.562；I² 23.1%，n=10项研究），空腹血糖（FBG）为-2.10mg/dL（95%置信区间-2.84至-1.36，异质性p=0.200；I² 42.6%，n=11项研究），糖化血红蛋白（HbA1c）为-0.83%（95%置信区间-1.08至-0.57，异质性p=0.856；I² 20.9%，n=11项研究）。这些发现在敏感性分析中很稳健。