钠-葡萄糖协同转运蛋白 2 抑制剂对血脂谱的影响：48 项随机对照试验的系统评价和荟萃分析。
Effect of sodium-glucose co-transporter 2 inhibitors on lipid profile: A systematic review and meta-analysis of 48 randomized controlled trials.
机构信息
Universidad Autónoma de Nuevo León, Endocrinology Division, Hospital Universitario "Dr. José E. González", Facultad de Medicina, Monterrey, NL, Mexico.
Universidad Autónoma de Nuevo León, Department of Orthopedics and Traumatology, Hospital Universitario "Dr. José E. González", Facultad de Medicina, Monterrey, NL, Mexico.
出版信息
Pharmacol Res. 2020 Oct;160:105068. doi: 10.1016/j.phrs.2020.105068. Epub 2020 Jul 8.
Previous studies have suggested additional beneficial effects of sodium-glucose co-transporter-2 (SGLT2) inhibitors including the lipid-lowering effect; however, results on lipid profile are controversial. Thus, this meta-analysis aimed to determine the effect of SGLT2 inhibitors treatment on lipid levels in patients with type 2 diabetes. Randomized controlled trials assessing the impact of SGLT2 inhibitors on lipid parameters were searched in PubMed-MEDLINE, SCOPUS, Web of Science, and Google Scholar databases. Meta-analysis was conducted using a random-effects model and generic inverse variance method. Meta-analysis of 48 randomized controlled trials revealed that SGLT2 inhibitors therapy had a significant increase on total cholesterol (WMD: 0.09 mmol/L, 95 % CI: 0.05, 0.13, I = 79 %, p < 0.0001), LDL-cholesterol (WMD: 0.10 mmol/L, 95 % CI: 0.07, 0.12, I = 94 %, p < 0.00001), HDL-cholesterol (WMD: 0.06 mmol/L, 95 % CI: 0.05, 0.08, I = 99 %, p < 0.00001), and non-HDL-cholesterol (WMD: 0.09 mmol/L, 95 % CI: 0.06, 0.12, I = 96 %, p < 0.00001). Additionally, SGLT2 inhibitors administration showed a significant decrease in triglyceride levels (WMD: -0.10 mmol/L, 95 % CI: -0.13, -0.07, I = 96 %, p < 0.00001). Finally, no significant alteration was found on LDL/HDL ratio after SGLT2 inhibitors treatment (WMD: -0.01 mmol/L, 95 % CI: -0.05, 0.03, I = 99 %, p = 0.65). In conclusion, SGLT2 inhibitors significantly increase total cholesterol, LDL-cholesterol, non-HDL-cholesterol, and HDL-cholesterol, and decrease triglyceride levels.
先前的研究表明，钠-葡萄糖共转运蛋白 2（SGLT2）抑制剂除了具有降血脂作用外，还有其他有益作用；然而，关于血脂谱的结果仍存在争议。因此，本荟萃分析旨在确定 SGLT2 抑制剂治疗对 2 型糖尿病患者血脂水平的影响。在 PubMed-MEDLINE、SCOPUS、Web of Science 和 Google Scholar 数据库中检索评估 SGLT2 抑制剂对血脂参数影响的随机对照试验。使用随机效应模型和通用逆方差法进行荟萃分析。对 48 项随机对照试验的荟萃分析表明，SGLT2 抑制剂治疗可显著增加总胆固醇（WMD：0.09mmol/L，95%CI：0.05，0.13，I = 79%，p <0.0001）、LDL-胆固醇（WMD：0.10mmol/L，95%CI：0.07，0.12，I = 94%，p <0.00001）、HDL-胆固醇（WMD：0.06mmol/L，95%CI：0.05，0.08，I = 99%，p <0.00001）和非 HDL-胆固醇（WMD：0.09mmol/L，95%CI：0.06，0.12，I = 96%，p <0.00001）。此外，SGLT2 抑制剂给药可显著降低甘油三酯水平（WMD：-0.10mmol/L，95%CI：-0.13，-0.07，I = 96%，p <0.00001）。最后，在 SGLT2 抑制剂治疗后，LDL/HDL 比值未见明显变化（WMD：-0.01mmol/L，95%CI：-0.05，0.03，I = 99%，p = 0.65）。总之，SGLT2 抑制剂可显著增加总胆固醇、LDL-胆固醇、非 HDL-胆固醇和 HDL-胆固醇，并降低甘油三酯水平。
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