Zhang Hongliang, Zhong Xiaobin, Huang Zhenguang, Huang Chun, Liu Taotao, Qiu Yue
Pharmacy Department, The First Affiliated Hospital of Guangxi Medical University, 530021, Nanning, China.
Guangxi Key Laboratory of Regenerative Medicine, The First Affiliated Hospital of Guangxi Medical University, 530021, Nanning, China.
Oncotarget. 2017 Nov 20;8(64):108274-108285. doi: 10.18632/oncotarget.22548. eCollection 2017 Dec 8.
The effect of sulfonylurea for the treatment of neonatal diabetes (NDM) is remain uncertain. We conducted this systematic review and meta-analysis to investigate the effect of sulfonylurea for NDM and to provide the latest and most convincing evidence for developing clinical practice guidelines of NDM. A literature review was performed to identify all published studies reporting the sulfonylurea on the treatment of neonatal diabetes. The search included the following databases: PUBMED, EMBASE and the Cochrane Library. The primary outcome was the success rates of treatment, change of glycosylated hemoglobin (HbA1c) and C-peptide. Data results were pooled by using MetaAnalyst with a random-effects model. Ten studies (6 cohort studies and 4 cross-sectional studies) involving 285 participants were included in the analysis. The pooled estimated success rate by the random-effects model was 90.1%(95% CI: 85.1%-93.5%). HbA1c had a significantly lower compared with before treatment. The pooled estimate of MD was -2.289, and the 95% CI was -2.790 to -1.789 ( < 0.001). The subgroup analysis showed a similar result for cohort studies and in cross-sectional studies. The common mild side effect is gastrointestinal reaction. The present meta-analysis suggested that sulfonylurea had a positive effect for treatment NDM due to K channel mutations. In addition, sulfonylurea also displayed sound safety except the mild gastrointestinal reaction. However, the findings rely chiefly on data from observational studies. Further well-conducted trials are required to assess sulfonylurea for NDM.
磺脲类药物治疗新生儿糖尿病（NDM）的效果仍不确定。我们进行了这项系统评价和荟萃分析，以研究磺脲类药物治疗NDM的效果，并为制定NDM临床实践指南提供最新且最具说服力的证据。通过文献回顾来识别所有已发表的报告磺脲类药物治疗新生儿糖尿病的研究。检索包括以下数据库：PUBMED、EMBASE和Cochrane图书馆。主要结局指标为治疗成功率、糖化血红蛋白（HbA1c）和C肽的变化。使用MetaAnalyst软件采用随机效应模型对数据结果进行汇总。分析纳入了10项研究（6项队列研究和4项横断面研究），共285名参与者。随机效应模型汇总估计的成功率为90.1%（95%CI：85.1%-93.5%）。与治疗前相比，HbA1c显著降低。MD的汇总估计值为-2.289，95%CI为-2.790至-1.789（P<0.001）。亚组分析显示队列研究和横断面研究结果相似。常见的轻度副作用是胃肠道反应。本荟萃分析表明，磺脲类药物对因钾通道突变导致的NDM治疗有积极作用。此外，除了轻度胃肠道反应外，磺脲类药物还显示出良好的安全性。然而，这些发现主要依赖于观察性研究的数据。需要进一步开展高质量的试验来评估磺脲类药物治疗NDM的效果。
