College of Pharmacy and Graduate School of Pharmaceutical Sciences, Ewha Womans University, Seoul, Republic of Korea.
J Clin Endocrinol Metab. 2022 Aug 18;107(9):2684-2690. doi: 10.1210/clinem/dgac333.
Although metformin is the first-line treatment for type 2 diabetes, the blood sugar-lowering effect of metformin varies among populations. SLC47A1 plays an important role in metformin pharmacokinetics and pharmacodynamics.
We performed a systematic review and meta-analysis to investigate the association between SLC47A1 rs2289669 (G > A) and the metformin response in drug-naive patients with type 2 diabetes.
Studies published until January 27, 2022, were retrieved from Cochrane CENTRAL, Embase, PubMed, and Web of Science. Two reviewers independently screened titles, abstracts, and full-text articles. Studies conducted in newly diagnosed or drug-naive patients with type 2 diabetes who received metformin monotherapy were included. A total of 6 studies involving 953 patients were included in this meta-analysis. We extracted the study characteristics and changes in glycated hemoglobin (HbA1c) levels before and after treatment according to the SLC47A1 rs2289669 genotype. Changes in HbA1c levels were analyzed using mean differences (MDs) and 95% CIs. SLC47A1 rs2289669 was associated with changes in HbA1c levels (A carrier vs GG; MD = -0.55; 95% CI, -0.91 to - 0.20; I² = 63%). The sensitivity analysis yielded similar results to the main analysis (MD range, -0.64 to -0.37). When comparing all 3 genotypes, there were significant differences in HbA1c level changes between AA vs GG and GA vs GG, but not in GA vs AA.
This meta-analysis showed that SLC47A1 rs2289669 is associated with the glycemic response to metformin in drug-naive patients with type 2 diabetes.
二甲双胍是 2 型糖尿病的一线治疗药物，但二甲双胍在不同人群中的降血糖效果存在差异。SLC47A1 在二甲双胍的药代动力学和药效学中起着重要作用。
我们进行了一项系统评价和荟萃分析，以研究 SLC47A1 rs2289669（G > A）与初治 2 型糖尿病患者使用二甲双胍的反应之间的关系。
检索 Cochrane 中心、Embase、PubMed 和 Web of Science 直到 2022 年 1 月 27 日发表的研究。两位审查员独立筛选标题、摘要和全文文章。纳入接受二甲双胍单药治疗的初诊或初治 2 型糖尿病患者的研究。这项荟萃分析共纳入了 6 项涉及 953 例患者的研究。我们根据 SLC47A1 rs2289669 基因型提取研究特征和治疗前后糖化血红蛋白（HbA1c）水平的变化。使用平均差值（MD）和 95%置信区间（CI）分析 HbA1c 水平的变化。SLC47A1 rs2289669 与 HbA1c 水平的变化相关（A 携带者与 GG；MD=-0.55；95%CI，-0.91 至-0.20；I²=63%）。敏感性分析得到的结果与主要分析相似（MD 范围，-0.64 至-0.37）。当比较所有 3 种基因型时，AA 与 GG 和 GA 与 GG 之间的 HbA1c 水平变化有显著差异，但 GA 与 AA 之间没有显著差异。
这项荟萃分析表明，SLC47A1 rs2289669 与初治 2 型糖尿病患者使用二甲双胍的血糖反应有关。
