阿卡波糖治疗对糖耐量受损和糖尿病患者心血管危险因素的影响：一项随机临床试验的系统评价和剂量反应荟萃分析
The effects of acarbose treatment on cardiovascular risk factors in impaired glucose tolerance and diabetic patients: a systematic review and dose-response meta-analysis of randomized clinical trials.
作者信息
Zamani Mohammad, Nikbaf-Shandiz Mahlagha, Aali Yasaman, Rasaei Niloufar, Zarei Mahtab, Shiraseb Farideh, Asbaghi Omid
机构信息
Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran.
Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran.
出版信息
Front Nutr. 2023 Aug 1;10:1084084. doi: 10.3389/fnut.2023.1084084. eCollection 2023.
Acarbose (ACB) seems to be an effective drug in the management of cardiovascular risk factors. However, no previous meta-analysis of randomized controlled trials (RCTs) has been done to evaluate the effects of ACB on cardiovascular risk factors on impaired glucose tolerance (IGT), type 2 diabetes mellitus (T2D), and type 1 diabetes mellitus (T1D). We comprehensively searched electronic databases including Scopus, Web of Science, and PubMed for RCTs for related keywords up to September 2022. A random-effects model was used to estimate the weighted mean difference (WMD) and 95% confidence interval (CI). The pooled analysis demonstrated that ACB treatment had a significant effect on fasting blood glucose (FBG) (WMD = -3.55 mg/dL; 95%CI: -6.29, -0.81; = 0.011), fasting insulin (WMD = -6.73 pmoL/L; 95%CI: -10.37, -3.10; < 0.001), HbA1c [WMD = -0.32%; 95%CI: -0.45, -0.20; < 0.001], body weight (WMD = -1.25 kg; 95%CI: -1.79, -0.75; < 0.001), body mass index (BMI) (WMD = -0.64 kg/m; 95%CI: -0.92, -0.37; < 0.001), tumor necrosis factor-alpha (TNF-α) (WMD = -2.70 pg/mL, 95%CI: -5.25, -0.16; = 0.037), leptin (WMD = -1.58 ng/mL; 95%CI: -2.82, -0.35; = 0.012), alanine transaminase (ALT) (WMD = 0.71 U/L; 95%CI: -0.31, 1.85; = 0.164), triglyceride (TG) (WMD = -13.89 mg/dL; 95%CI: -20.69, -7.09; < 0.001), total cholesterol (TC) (WMD = -2.26 mg/dL; 95%CI: -4.18, -0.34; = 0.021), systolic blood pressure (SBP) (WMD = -1.29 mmHg; 95%CI: -2.44, -0.15; = 0.027), and diastolic blood pressure (DBP) (WMD = 0.02 mmHg; 95%CI: -0.41, 0.45; = 0.925) in an intervention group, compared with a placebo group. The non-linear dose-response analysis showed that ACB reduces the TC in trial duration by >50 weeks, and 180 mg/day is more effective for the decrement of CRP. ACB can improve lipid profiles, glycemic indices, anthropometric indices, and inflammatory markers in T2D, T1D, and IGT patients.
阿卡波糖（ACB）似乎是一种用于管理心血管危险因素的有效药物。然而，此前尚未有对随机对照试验（RCT）进行的荟萃分析来评估ACB对糖耐量受损（IGT）、2型糖尿病（T2D）和1型糖尿病（T1D）患者心血管危险因素的影响。我们全面检索了包括Scopus、科学网和PubMed在内的电子数据库，以查找截至2022年9月的相关关键词的随机对照试验。采用随机效应模型来估计加权平均差（WMD）和95%置信区间（CI）。汇总分析表明，与安慰剂组相比，干预组中ACB治疗对空腹血糖（FBG）（WMD = -3.55 mg/dL；95%CI：-6.29，-0.81；P = 0.011）、空腹胰岛素（WMD = -6.73 pmoL/L；95%CI：-10.37，-3.10；P < 0.001）、糖化血红蛋白（HbA1c）[WMD = -0.32%；95%CI：-0.45，-0.20；P < 0.001]、体重（WMD = -1.25 kg；95%CI：-1.79，-0.75；P < 0.001）、体重指数（BMI）（WMD = -0.64 kg/m²；95%CI：-0.92，-0.37；P < 0.001）、肿瘤坏死因子-α（TNF-α）（WMD = -2.70 pg/mL，95%CI：-5.25，-0.16；P = 0.037）、瘦素（WMD = -1.58 ng/mL；95%CI：-2.82，-0.35；P = 0.012）、丙氨酸转氨酶（ALT）（WMD = 0.71 U/L；95%CI：-0.31，1.85；P = 0.164）、甘油三酯（TG）（WMD = -13.89 mg/dL；95%CI：-20.69，-7.09；P < 0.001）、总胆固醇（TC）（WMD = -2.26 mg/dL；95%CI：-4.18，-0.34；P = 0.021）、收缩压（SBP）（WMD = -1.29 mmHg；95%CI：-2.44，-0.15；P = 0.027）和舒张压（DBP）（WMD = 0.02 mmHg；95%CI：-0.41，0.45；P = 0.925）均有显著影响。非线性剂量反应分析表明，ACB在试验持续时间超过50周时可降低TC，且每日180 mg对降低C反应蛋白（CRP）更有效。ACB可改善T2D、T1D和IGT患者的血脂谱、血糖指标、人体测量指标和炎症标志物。
Zotero 插件