Department of Nephrology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
Department of Hemotology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
Lipids Health Dis. 2024 May 25;23(1):157. doi: 10.1186/s12944-024-02132-x.
About 20-40% patients with type 2 diabetes mellitus (T2DM) had an increased risk of developing diabetic nephropathy (DN). Dipeptidyl peptidase-4 inhibitors (DPP-4i) were recommended for treatment of T2DM, while the impact of DPP-4i on renal function remained unclear. This study aimed to explore the effect of DPP-4i on renal parameter of estimated glomerular filtration rate (eGFR) and albumin-to-creatinine ratio (ACR) in T2DM.
A systematic search was performed across PubMed, Embase and Cochrane Library. A fixed or random-effects model was used for quantitative synthesis according to the heterogeneity, which was assessed with I index. Sensitivity analysis and publication bias were performed with standard methods, respectively.
A total of 17 randomized controlled trials were identified. Administration of DPP-4i produced no significant effect on eGFR (WMD, -0.92 mL/min/1.73m, 95% CI, -2.04 to 0.19) in diabetic condition. DPP-4i produced a favorable effect on attenuating ACR (WMD, -2.76 mg/g, 95% CI, -5.23 to -0.29) in patients with T2DM. The pooled estimate was stable based on the sensitivity test. No publication bias was observed according to Begg's and Egger's tests.
Treatment with DPP-4i preserved the renal parameter of eGFR in diabetic condition. Available evidences suggested that administration of DPP-4i produced a favorable effect on attenuating ACR in patients with T2DM. INTERNATIONAL PROSPECTIVE REGISTER FOR SYSTEMATIC REVIEW (PROSPERO) NUMBER: CRD.42020144642.
约 20-40%的 2 型糖尿病（T2DM）患者发生糖尿病肾病（DN）的风险增加。二肽基肽酶-4 抑制剂（DPP-4i）被推荐用于治疗 T2DM，但其对肾功能的影响尚不清楚。本研究旨在探讨 DPP-4i 对 T2DM 患者估算肾小球滤过率（eGFR）和白蛋白与肌酐比值（ACR）肾参数的影响。
通过 PubMed、Embase 和 Cochrane Library 进行系统检索。根据异质性评估，采用固定或随机效应模型进行定量综合，采用 I 指数进行评估。分别采用标准方法进行敏感性分析和发表偏倚分析。
共纳入 17 项随机对照试验。在糖尿病状态下，DPP-4i 给药对 eGFR 没有显著影响（WMD，-0.92 mL/min/1.73m，95%CI，-2.04 至 0.19）。DPP-4i 对降低 T2DM 患者的 ACR 有有利影响（WMD，-2.76 mg/g，95%CI，-5.23 至-0.29）。基于敏感性检验，汇总估计值是稳定的。根据 Begg 和 Egger 检验，未观察到发表偏倚。
DPP-4i 治疗可维持糖尿病状态下的 eGFR 肾参数。现有证据表明，DPP-4i 给药对降低 T2DM 患者的 ACR 有有利影响。国际前瞻性系统评价注册（PROSPERO）编号：CRD.42020144642。
