School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, Hong Kong, China.
Department of Applied Biology and Chemical Technology, The Hong Kong Polytechnic University, Kowloon, Hong Kong, China.
Obes Rev. 2021 Dec;22(12):e13336. doi: 10.1111/obr.13336. Epub 2021 Sep 20.
Several meta-analyses have been conducted to evaluate the weight loss effect of sodium-glucose cotransporter 2 (SGLT-2) inhibitors in patients with type 2 diabetes, whereas pooled analysis focusing on individuals without diabetes is lacking. The objective of this systematic review and meta-analysis is to evaluate the effect of SGLT-2 inhibitor monotherapy on weight change and cardiometabolic profiles. Multiple databases were searched for randomized controlled trials reporting weight change effect of SGLT-2 inhibitor treatment compared with placebo for more than 12 weeks among individuals with overweight or obesity and without diabetes. A total of eight randomized controlled trials with 750 subjects were identified. SGLT-2 monotherapy was associated with significant reduction in body weight of -2.32 kg, compared to -1.01 kg for placebo, giving a mean difference of -1.31 kg. Significant reductions in body mass index and fasting blood glucose were observed, but not for the changes in waist circumference, fat mass, blood pressure, and lipid profile compared with placebo. SGLT-2 inhibitor monotherapy for 12 weeks or more can result in modest weight loss among people with overweight or obesity and without diabetes. Depending on pre-existing comorbidities or risk factors, SGLT-2 inhibitors can be considered adjuncts in the treatment of obesity.
已有多项荟萃分析评估了钠-葡萄糖共转运蛋白 2(SGLT-2)抑制剂在 2 型糖尿病患者中的减肥效果,而缺乏针对无糖尿病个体的汇总分析。本系统评价和荟萃分析的目的是评估 SGLT-2 抑制剂单药治疗对体重变化和心脏代谢特征的影响。我们检索了多个数据库,以寻找报告 SGLT-2 抑制剂治疗与安慰剂相比在超重或肥胖且无糖尿病的个体中治疗超过 12 周时体重变化影响的随机对照试验。确定了八项涉及 750 名受试者的随机对照试验。与安慰剂相比,SGLT-2 单药治疗可显著降低体重,降幅为-2.32kg,而安慰剂组为-1.01kg,平均差异为-1.31kg。与安慰剂相比,观察到体重指数和空腹血糖显著降低,但腰围、脂肪量、血压和血脂谱的变化没有显著降低。SGLT-2 抑制剂单药治疗 12 周或更长时间可导致超重或肥胖且无糖尿病的人群体重适度减轻。根据现有的合并症或危险因素,SGLT-2 抑制剂可考虑作为肥胖治疗的辅助药物。