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胰高血糖素样肽-1 受体激动剂治疗 2 型糖尿病合并非酒精性脂肪性肝病的 Meta 分析。

Glucagon-Like Peptide-1 Receptor Agonists for Non-Alcoholic Fatty Liver Disease in Type 2 Diabetes: A Meta-Analysis.

机构信息

Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.

Department of Biological Sciences, Faculty of Science, National University of Singapore, Singapore, Singapore.

出版信息

Front Endocrinol (Lausanne). 2021 Apr 9;12:609110. doi: 10.3389/fendo.2021.609110. eCollection 2021.

Abstract

OBJECTIVE

Non-alcoholic fatty liver disease is highly prevalent in patients with type 2 diabetes mellitus. Studies on glucagon-like peptide-1 receptor agonists for the treatment of non-alcoholic fatty liver disease have reported promising results. Despite this, there has been limited evidence of its efficacy in non-alcoholic fatty liver disease patients with type 2 diabetes mellitus. This meta-analysis examined existing evidence on the efficacy of glucagon-like peptide-1 receptor agonists on the management of non-alcoholic fatty liver disease in patients with type 2 diabetes mellitus.

METHODS

Medline, Embase and Cochrane Central Register of Controlled Trials (CENTRAL) were searched for articles discussing the efficacy of glucagon-like peptide-1 receptor agonists on non-alcoholic fatty liver disease in patients with type 2 diabetes mellitus. Values of standardized mean differences (SMD) and risk ratio (RR) were determined for continuous outcomes and dichotomous outcomes respectively.

RESULTS

8 studies involving 1,454 patients from 5 randomized controlled trials and 3 cohort studies were included in the analysis. Our analysis found significant improvements in hepatic fat content, liver biochemistry, body composition, glucose parameters, lipid parameters, insulin sensitivity and inflammatory markers following glucagon-like peptide-1 receptor agonist treatment. Glucagon-like peptide-1 receptor agonists significantly decreased hepatic fat content compared to metformin and insulin-based therapies. Glucagon-like peptide-1 receptor agonists also improved fibrosis markers, but this did not reach statistical significance.

CONCLUSION

With a high prevalence of obesity and non-alcoholic fatty liver disease among patients with type 2 diabetes mellitus, glucagon-like peptide-1 receptor agonist treatment shows promise in improving both diabetes and non-alcoholic fatty liver disease phenotype.

摘要

目的

非酒精性脂肪性肝病在 2 型糖尿病患者中高发。研究发现胰高血糖素样肽-1 受体激动剂(GLP-1RA)治疗非酒精性脂肪性肝病具有良好的效果。然而,在 2 型糖尿病合并非酒精性脂肪性肝病患者中,其疗效的证据有限。本荟萃分析旨在评估 GLP-1RA 治疗 2 型糖尿病合并非酒精性脂肪性肝病患者的疗效。

方法

检索 Medline、Embase 和 Cochrane 对照试验中心注册库(CENTRAL),查找关于 GLP-1RA 治疗 2 型糖尿病合并非酒精性脂肪性肝病疗效的文章。分别对连续结局和二分类结局采用标准化均数差(SMD)和风险比(RR)进行评估。

结果

纳入 5 项随机对照试验和 3 项队列研究共 8 项研究,共计 1454 例患者。分析结果显示,GLP-1RA 治疗可显著改善肝脏脂肪含量、肝功能、体成分、血糖参数、血脂参数、胰岛素敏感性和炎症标志物。与二甲双胍和胰岛素治疗相比,GLP-1RA 可显著降低肝脏脂肪含量。GLP-1RA 还可改善肝纤维化标志物,但未达到统计学意义。

结论

鉴于 2 型糖尿病患者肥胖和非酒精性脂肪性肝病的高发,GLP-1RA 治疗可能对改善糖尿病和非酒精性脂肪性肝病表型具有良好的效果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d785/8063104/42de5924d5aa/fendo-12-609110-g001.jpg

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