Masson Walter, Lobo Martín, Nogueira Juan Patricio, Rodriguez-Granillo Alfredo Matias, Barbagelata Leandro Ezequiel, Siniawski Daniel
Department of Cardiology, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina.
Department of Cardiology, Hospital Militar Campo de Mayo, Buenos Aires, Argentina.
Front Cardiovasc Med. 2024 Jul 5;11:1379189. doi: 10.3389/fcvm.2024.1379189. eCollection 2024.
The anti-inflammatory effect could be one of the mechanisms by which semaglutide reduces cardiovascular risk in patients with type 2 diabetes mellitus (T2DM) and/or obesity. Determining the anti-inflammatory effect of semaglutide was the objective of this systematic review and meta-analysis.
This meta-analysis was performed according to the PRISMA guidelines. A literature search was performed to detect randomised clinical trials that have quantified the effect of semaglutide on C-reactive protein (CRP) levels compared to placebo or a control group (other glucose-lowering drugs). The primary outcome was CRP index (final CRP/basal CRP). A random-effects model was used.
Thirteen randomised clinical trials were considered eligible ( = 26,131). Overall, semaglutide therapy was associated with lower CRP index values compared to the placebo group (SMD -0.56; 95% CI -0.69 to -0.43, 92%) or the control group (SMD -0.45; 95% CI -0.68 to -0.23, 82%).Such an association was similarly observed when different treatment regimens (subcutaneous vs. oral) or different populations (patients with or without T2DM) were analysed. The sensitivity analysis showed that the results were robust.
The present meta-analysis demonstrated that the use of semaglutide was associated with a reduction in inflammation irrespective of the population evaluated or the treatment regimen used. These findings would explain one of the mechanisms by which semaglutide reduces cardiovascular events.
PROSPERO [CRD42024500551].
抗炎作用可能是司美格鲁肽降低2型糖尿病（T2DM）和/或肥胖患者心血管风险的机制之一。确定司美格鲁肽的抗炎作用是本系统评价和荟萃分析的目的。
本荟萃分析按照PRISMA指南进行。进行文献检索以检测与安慰剂或对照组（其他降糖药物）相比，已对司美格鲁肽对C反应蛋白（CRP）水平的影响进行量化的随机临床试验。主要结局为CRP指数（最终CRP/基础CRP）。采用随机效应模型。
13项随机临床试验被认为符合纳入标准（n = 26,131）。总体而言，与安慰剂组（标准化均值差-0.56；95%置信区间-0.69至-0.43，P < 0.001）或对照组（标准化均值差-0.45；95%置信区间-0.68至-0.23，P < 0.001）相比，司美格鲁肽治疗与较低的CRP指数值相关。在分析不同治疗方案（皮下注射与口服）或不同人群（有或无T2DM的患者）时，也观察到了类似的关联。敏感性分析表明结果稳健。
本荟萃分析表明，无论评估的人群或使用的治疗方案如何，使用司美格鲁肽均与炎症减轻相关。这些发现将解释司美格鲁肽降低心血管事件的机制之一。
PROSPERO [CRD42024500551]
