二肽基肽酶4抑制剂作为神经保护药物对2型糖尿病患者认知障碍的影响：一项荟萃分析与系统评价
Effects of DPP4 Inhibitors as Neuroprotective Drug on Cognitive Impairment in Patients with Type 2 Diabetes Mellitus: A Meta-Analysis and Systematic Review.
作者信息
Yuan Yuting, Zhang Yue, Lei Min, Guo Xiying, Yang Xiaosong, Ouyang Changhan, Liu Chao, Chen Qingjie
机构信息
School of Pharmacy, Xianning Medical College, Hubei University of Science and Technology, Xianning, Hubei, China.
Hubei Key Laboratory of Diabetes and Angiopathy, Medicine Research Institute, Xianning Medical College, Hubei University of Science and Technology, Xianning, Hubei, China.
出版信息
Int J Endocrinol. 2024 Feb 13;2024:9294113. doi: 10.1155/2024/9294113. eCollection 2024.
PURPOSE
Type 2 diabetes mellitus is considered as one of the risk factors for cognitive impairment. DPP4 inhibitors are effective drugs for the treatment of type 2 diabetes mellitus. However, the relationship between DPP4 inhibitors and cognitive dysfunction remains unclear. Therefore, we used a meta-analysis to determine the association between DPP4 inhibitors and cognitive impairment in type 2 diabetes mellitus.
METHODS
We systematically searched PubMed, CNKI, and the Cochrane Library at the time of establishment, 2022, and then made inclusion criteria and screened strategies to identify studies with more precise correlations.
RESULTS
We included 10 studies with 5,583 participants. The data showed that DPP4 inhibitors significantly reduced the incidence rate of cognitive impairment in type 2 diabetes mellitus (SMD: 0.99; 95% CI [0.59, 1.38]). Furthermore, there was a linear correlation found between cognitive impairment in type 2 diabetes mellitus and fasting blood glucose, 2-hour postprandial blood glucose, and glycosylated hemoglobin. DPP4 inhibitors decreased fasting blood glucose (FPG) (SMD: 0.52; 95% CI [-0.68, -0.37]), blood glucose (2hPPG) at 2 hours after the meal (SMD: 0.82; 95% CI, [-1.2, -0.43]), and HbA1c (SMD: 0.34; 95% CI [-0.48, -0.21]). All data were statistically significant ( < 0.0001). Furthermore, we conducted subgroup analyses of the following measures at various treatment durations and ages: cognitive scores, fasting blood glucose, glycosylated hemoglobin, and two-hour postprandial blood glucose.
CONCLUSION
DPP4 inhibitors significantly improved type 2 diabetic mellitus individuals' cognitive impairment and reduced fasting blood glucose, 2-hour postprandial blood glucose, and glycosylated hemoglobin. Subgroup analysis showed that people aged 60 to 70 years had better treatment effects at 0-180 days. This trial is registered with CRD42023399473.
目的
2型糖尿病被认为是认知障碍的危险因素之一。二肽基肽酶4（DPP4）抑制剂是治疗2型糖尿病的有效药物。然而，DPP4抑制剂与认知功能障碍之间的关系仍不清楚。因此，我们进行了一项荟萃分析，以确定DPP4抑制剂与2型糖尿病患者认知障碍之间的关联。
方法
我们在2022年成立时系统检索了PubMed、中国知网（CNKI）和考克兰图书馆，然后制定纳入标准和筛选策略，以确定具有更精确相关性的研究。
结果
我们纳入了10项研究，共5583名参与者。数据显示，DPP4抑制剂显著降低了2型糖尿病患者认知障碍的发生率（标准化均数差：0.99；95%置信区间[0.59, 1.38]）。此外，发现2型糖尿病患者的认知障碍与空腹血糖、餐后2小时血糖和糖化血红蛋白之间存在线性相关性。DPP4抑制剂降低了空腹血糖（FPG）（标准化均数差：0.52；95%置信区间[-0.68, -0.37]）、餐后2小时血糖（2hPPG）（标准化均数差：0.82；95%置信区间[-1.2, -0.43]）和糖化血红蛋白（标准化均数差：0.34；95%置信区间[-0.48, -0.21]）。所有数据均具有统计学意义（P < 0.0001）。此外，我们在不同治疗持续时间和年龄对以下指标进行了亚组分析：认知评分、空腹血糖、糖化血红蛋白和餐后2小时血糖。
结论
DPP4抑制剂显著改善了2型糖尿病患者的认知障碍，并降低了空腹血糖、餐后2小时血糖和糖化血红蛋白。亚组分析表明，60至70岁的人群在0至180天的治疗效果更好。本试验已在国际前瞻性注册库（CRD）注册，注册号为CRD42023399473。
Zotero 插件