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胰高血糖素样肽-1 受体激动剂对成人血糖控制和体重减轻的影响:多变量荟萃分析。

Effect of glucagon-like peptide-1 receptor agonists on glycemic control, and weight reduction in adults: A multivariate meta-analysis.

机构信息

Department of Family Medicine, Hsinchu MacKay Memorial Hospital, Hsinchu, Taiwan.

Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan.

出版信息

PLoS One. 2023 Jan 25;18(1):e0278685. doi: 10.1371/journal.pone.0278685. eCollection 2023.

Abstract

AIMS

To explore the effect of glucagon-like peptide-1 receptor agonist (GLP-1 RAs) on glycemic control and weight reduction in adults.

METHODS

Databases were searched from August 2021 to March 2022. Data were analyzed using mean difference (MD) values with 95% confidence intervals (CIs). Both random-and fixed-effect models were employed. Heterogeneity was explored using pre-specified subgroup analyses and meta-regression. Structural equation modeling fitting was used for the multivariate meta-analysis.

RESULTS

A total of 31 double-blind randomized controlled trials with 22,948 participants were included in the meta-analysis. The MD and 95% CI of the pooled GLP1-RA-induced change in the glycated hemoglobin level was -0.78% (-0.97%, -0.60%) in the random-effects model and -0.45% (-0.47%, -0.44%) in the fixed-effect model, with a high heterogeneity (I2 = 97%). The pooled body weight reduction was -4.05 kg (-5.02 kg, -3.09 kg) in the random-effects model and -2.04 kg (-2.16 kg, -1.92 kg) in the fixed-effect model (I2 = 98%). The standardized pooled correlation coefficient between HbA1c levels and body weight was -0.42. A negative correlation between glycemic control and weight reduction was obtained.

CONCLUSION

Long-acting GLP-1 RAs significantly reduced the glycated hemoglobin level and body weight in adults.

摘要

目的

探讨胰高血糖素样肽-1 受体激动剂(GLP-1 RAs)对成人血糖控制和体重减轻的影响。

方法

从 2021 年 8 月至 2022 年 3 月检索数据库。使用均值差(MD)值和 95%置信区间(CI)进行数据分析。采用随机效应模型和固定效应模型。使用预先指定的亚组分析和荟萃回归探索异质性。结构方程模型拟合用于多变量荟萃分析。

结果

共纳入 31 项双盲随机对照试验,22948 名参与者。荟萃分析中,GLP1-RA 引起的糖化血红蛋白水平变化的 MD 和 95%CI 在随机效应模型中为-0.78%(-0.97%,-0.60%),在固定效应模型中为-0.45%(-0.47%,-0.44%),异质性较高(I2=97%)。体重减轻的合并值在随机效应模型中为-4.05kg(-5.02kg,-3.09kg),在固定效应模型中为-2.04kg(-2.16kg,-1.92kg)(I2=98%)。HbA1c 水平与体重之间的标准化合并相关系数为-0.42。得到了血糖控制与体重减轻之间的负相关关系。

结论

长效 GLP-1 RAs 可显著降低成人的糖化血红蛋白水平和体重。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/61e8/9876280/2820d019fb11/pone.0278685.g001.jpg

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