Department of General Surgery, HwaMei Hospital, University of Chinese Academy of Sciences, Ningbo, China.
Ningbo Institute of Life and Health Industry, University of Chinese Academy of Sciences, Ningbo, China.
Front Endocrinol (Lausanne). 2022 May 26;13:907340. doi: 10.3389/fendo.2022.907340. eCollection 2022.
This meta-analysis was conducted to explore the association between sodium-glucose cotransporter 2 inhibitors (SGLT-2is) and ocular diseases in type 2 diabetes mellitus (T2DM) patients.
PubMed, Cochrane Central Registry of Controlled Trials, Web of Science and Springer were searched for articles on randomized controlled trials (RCTs) involving T2DM patients treated with SGLT-2i versus placebo or other hypoglycemic agents published prior to August 2021. The primary outcome of this meta-analysis was incidence of ocular diseases, which was assessed using risk ratios (RR) and 95% confidence intervals (CI). We reviewed 47 papers and compared the effect of SGLT-2i with the effect of the control groups (placebo and other hypoglycemic drugs) on the incidence of ocular diseases.
Compared with controls, overall SGLT-2i use in T2DM patients was not associated with incidences of cataract, glaucoma, retinal disease and vitreous disease. Ertugliflozin (RR=0.47, P=0.01) reduced the risk for retinal disease, while empagliflozin (RR=0.44, P=0.05) reduced the risk for diabetic retinopathy (DR) compared with controls. SGLT-2i (RR=0.50, P=0.02), perhaps empagliflozin (RR=0.47, P=0.06), reduced the risk of retinal disease compared with active hypoglycemic agents. Canagliflozin (RR=4.50, P=0.03) increased the risk for vitreous disease compared with placebo.
There was no significant correlation between overall SGLT-2i and ocular diseases (cataract, glaucoma, retinal disease, vitreous disease, corneal disease, conjunctival disease, uveal disease, eye haemorrhage and vision problems) in T2DM patients. Ertugliflozin and empagliflozin may protect against ocular diseases, but canagliflozin may promote ocular diseases.
本荟萃分析旨在探讨钠-葡萄糖共转运蛋白 2 抑制剂（SGLT-2i）与 2 型糖尿病（T2DM）患者眼部疾病的关系。
检索 PubMed、Cochrane 对照试验中心注册库、Web of Science 和 Springer 数据库，收集截至 2021 年 8 月发表的关于 SGLT-2i 治疗 T2DM 患者与安慰剂或其他降糖药物对照的随机对照试验（RCT）的文章。本荟萃分析的主要结局为眼部疾病的发生率，采用风险比（RR）和 95%置信区间（CI）进行评估。我们共查阅了 47 篇论文，并比较了 SGLT-2i 与对照组（安慰剂和其他降糖药物）对眼部疾病发生率的影响。
与对照组相比，T2DM 患者总体 SGLT-2i 治疗与白内障、青光眼、视网膜疾病和玻璃体疾病的发生率无关。与对照组相比，恩格列净（RR=0.47，P=0.01）可降低视网膜疾病的风险，而埃格列净（RR=0.44，P=0.05）可降低糖尿病视网膜病变（DR）的风险。与对照组相比，SGLT-2i（RR=0.50，P=0.02），可能还有恩格列净（RR=0.47，P=0.06），降低了视网膜疾病的风险。与活性降糖药物相比，卡格列净（RR=4.50，P=0.03）增加了玻璃体疾病的风险。
总体而言，SGLT-2i 与 T2DM 患者的眼部疾病（白内障、青光眼、视网膜疾病、玻璃体疾病、角膜疾病、结膜疾病、葡萄膜疾病、眼部出血和视力问题）无显著相关性。恩格列净和埃格列净可能对眼部疾病有保护作用，但卡格列净可能会促进眼部疾病的发生。
