质子泵抑制剂对 2 型糖尿病患者糖和胰岛素代谢的影响：一项随机对照试验的系统评价和荟萃分析。

Effect of Proton-Pump Inhibitors on Glucose and Insulin Metabolism on Patients with Type 2 Diabetes: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

机构信息

Endocrinology Division, Hospital Universitario "Dr. Jose E. Gonzalez", Facultad de Medicina, Universidad Autonoma de Nuevo Leon, Monterrey, NL, Mexico.

Department of Orthopedics and Traumatology, Hospital Universitario "Dr. Jose E. Gonzalez", Facultad de Medicina, Universidad Autonoma de Nuevo Leon, Monterrey, NL, Mexico.

出版信息

Curr Pharm Des. 2020;26(32):4007-4013. doi: 10.2174/1381612826666200523170718.

DOI:10.2174/1381612826666200523170718

PMID:32445448

Abstract

BACKGROUND

Some studies have revealed an improvement in glucose metabolism after proton-pump inhibitors (PPI) therapy; however, this evidence is inconclusive and limited.

OBJECTIVE

The study aimed to examine the effect of PPI on glucose and insulin metabolism in patients with type 2 diabetes through a systematic review and meta-analysis.

METHODS

Only randomized controlled trials evaluating the impact of PPI on glucose or insulin concentrations in type 2 diabetes were searched in PubMed-Medline, SCOPUS, Web of Science and Google Scholar databases. A meta-analysis was conducted using a random-effects model and generic inverse variance method. Sensitivity analysis was performed using the leave-one-out method.

RESULTS

Meta-analysis revealed no significant effect of PPI intervention on fasting glucose (mean difference [MD] -11.42 [95% CI, -29.68 to 6.83], I2 = 80%, p = 0.22), fasting insulin (MD 1.51 [95% CI, -0.36 to 3.37], I2 = 32%, p = 0.11), HOMA-IR (MD -0.16 [-0.98 to 0.65], I2 = 0%, p = 0.70), HOMA-β (MD 19.97 [-21.59 to 61.52], I2 = 71%, p = 0.35), and HbA1c concentrations (MD -0.34 [-0.99 to 0.31], I2 = 89%, p = 0.30).

CONCLUSION

The treatment with PPI, in the short term, had no significant effects on glucose and insulin metabolism in patients with type 2 diabetes.

摘要

背景

一些研究表明质子泵抑制剂（PPI）治疗后葡萄糖代谢得到改善，但这方面的证据并不明确且有限。

目的

本研究旨在通过系统评价和荟萃分析来检验 PPI 对 2 型糖尿病患者葡萄糖和胰岛素代谢的影响。

方法

仅检索了在 PubMed-Medline、SCOPUS、Web of Science 和 Google Scholar 数据库中评估 PPI 对 2 型糖尿病患者葡萄糖或胰岛素浓度影响的随机对照试验。采用随机效应模型和通用逆方差法进行荟萃分析。采用逐一剔除法进行敏感性分析。

结果

荟萃分析显示，PPI 干预对空腹血糖（MD-11.42[95%CI，-29.68 至 6.83]，I2=80%，p=0.22）、空腹胰岛素（MD 1.51[95%CI，-0.36 至 3.37]，I2=32%，p=0.11）、HOMA-IR（MD-0.16[-0.98 至 0.65]，I2=0%，p=0.70）、HOMA-β（MD 19.97[-21.59 至 61.52]，I2=71%，p=0.35）和 HbA1c 浓度（MD-0.34[-0.99 至 0.31]，I2=89%，p=0.30）均无显著影响。