Dar Sophia, Siddiqi Ahmed Kamal, Alabduladhem Tamim Omar, Rashid Ahmed Mustafa, Sarfraz Saba, Maniya Talha, Menezes Ritesh G, Almas Talal
Hackensack University Medical Center, Hackensack, NJ, United States.
Department of Medicine, Ziauddin Medical University, Karachi, Pakistan.
Ann Med Surg (Lond). 2022 Apr 16;77:103633. doi: 10.1016/j.amsu.2022.103633. eCollection 2022 May.
We aim to evaluate the impacts of sodium-glucose co-transporter 2 inhibitors (SGLT-2), glucagon-like peptide 1 agonist (GLP-1RAs), and dipeptidyl peptidase-four (DPP4) inhibitors on the levels of high-density lipoprotein, low-density lipoprotein, triglyceride and total cholesterol.
The MEDLINE database was searched from inception till October 2021, for randomized controlled trials assessing the effects of sodium-glucose co-transporter two inhibitors (SGLT-2), glucagon-like peptide 1 agonist (GLP-1RAs), and dipeptidyl peptidase-four (DPP4) inhibitors on lipid levels.
A total of 57 trials were included in the analysis. Our pooled analysis demonstrates that SGLT-2 inhibitors significantly increase the levels of HDL (WMD = 0.07 mg/dL [0.06 to 0.08], P < 0.00001). SGLT-2 inhibitors were also found to be significantly associated with an increase in the levels of LDL (WMD = 0.11 mg/dL, [0.09-0.13 mg/dL, P < 0.00001). Pooled analysis also demonstrates that SGLT-2 inhibitors significantly reduce the levels of triglyceride (WMD = -0.10 mg/dL, [-0.13 to -0.06], P < 0.00001). Our pooled analysis demonstrates that SGLT-2 inhibitors significantly increased the levels of total cholesterol (WMD = 0.10 mg/dL, [0.06 to 0.15], P < 0.0001), whereas, GLP-1RAs significantly reduced the levels of total cholestrol (WMD = -0.18 mg/dL, [-0.34 to -0.02], P = 0.03).
This is the first head-to-head study comparing the effects of 3-novel glucose-lowering agents to lipid parameters. However, more trials are crucial to better understand the impact of glucose-lowering drugs on lipid parameters.
我们旨在评估钠-葡萄糖协同转运蛋白2抑制剂（SGLT-2）、胰高血糖素样肽1激动剂（GLP-1RAs）和二肽基肽酶-4（DPP4）抑制剂对高密度脂蛋白、低密度脂蛋白、甘油三酯和总胆固醇水平的影响。
检索MEDLINE数据库自创建至2021年10月的文献，查找评估钠-葡萄糖协同转运蛋白2抑制剂（SGLT-2）、胰高血糖素样肽1激动剂（GLP-1RAs）和二肽基肽酶-4（DPP4）抑制剂对血脂水平影响的随机对照试验。
共有57项试验纳入分析。我们的汇总分析表明，SGLT-2抑制剂显著提高高密度脂蛋白水平（加权均数差=0.07mg/dL[0.06至0.08]，P<0.00001）。还发现SGLT-2抑制剂与低密度脂蛋白水平升高显著相关（加权均数差=0.11mg/dL，[0.09 - 0.13mg/dL，P<0.00001]）。汇总分析还表明，SGLT-2抑制剂显著降低甘油三酯水平（加权均数差=-0.10mg/dL，[-0.13至-0.06]，P<0.00001）。我们的汇总分析表明，SGLT-2抑制剂显著提高总胆固醇水平（加权均数差=0.10mg/dL，[0.06至0.15]，P<0.0001），而GLP-1RAs显著降低总胆固醇水平（加权均数差=-0.18mg/dL，[-0.34至-0.02]，P = 0.03）。
这是第一项比较三种新型降糖药物对血脂参数影响的直接对比研究。然而，需要更多试验来更好地了解降糖药物对血脂参数的影响。
