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二甲双胍治疗慢性心力衰竭的2型糖尿病患者的临床结局:一项荟萃分析。

Clinical outcomes in type 2 diabetes patients with chronic heart failure treated with metformin: a meta-analysis.

作者信息

Huang Wenxia, Zhao Rongchen

机构信息

Department of Cardiovascular Medicine, Hainan General Hospital Hainan Affiliated Hospital of Hainan Medical University, Haikou, Hainan, China.

Department of Respiratory and Critical Care Medicine, The Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, Shandong Province, China.

出版信息

Endocrine. 2025 Feb;87(2):436-447. doi: 10.1007/s12020-024-04025-6. Epub 2024 Sep 15.

Abstract

OBJECTIVE

To explore outcomes of metformin (Met) as an antihyperglycemic agent in patients with type 2 diabetes mellitus (T2DM) combined with chronic heart failure (CHF).

METHODS

This article employed a meta-analysis approach to systematically search several databases. Stata 15.1 software was employed for statistical analysis.

RESULTS

This meta-analysis encompassed 15 randomized controlled trials, involving 20,595 patients with T2DM and CHF. The results revealed that in comparison to the non-Met group, the Met group exhibited a significantly reduced risk of all-cause mortality (RR = 0.72, 95%CI: 0.60-0.87) and a notably lower risk of cardiovascular mortality (RR = 0.52, 95%CI:0.29-0.92). However, there was no significant difference in the risk of hospitalization due to heart failure (RR = 0.85, 95%CI: 0.70-1.04). Furthermore, the Met group demonstrated significant improvements in NT-proBNP levels compared to the non-Met group (WMD = -132.91, 95%CI: -173.03, -92.79). Regarding the enhancement of Left Ventricular Ejection Fraction and Left Ventricular End-Diastolic Dimension levels, no statistically significant differences were observed between the two groups.

CONCLUSION

In individuals with T2DM and CHF, the use of Met is linked to a decreased likelihood of all-cause mortality and cardiovascular-related mortality. Furthermore, it can enhance cardiac function in CHF patients without elevating the risk of hospitalization due to heart failure, establishing its safety and potential benefits.

摘要

目的

探讨二甲双胍(Met)作为降糖药物在2型糖尿病(T2DM)合并慢性心力衰竭(CHF)患者中的疗效。

方法

本文采用荟萃分析方法系统检索多个数据库。使用Stata 15.1软件进行统计分析。

结果

该荟萃分析纳入了15项随机对照试验,涉及20595例T2DM合并CHF患者。结果显示,与非Met组相比,Met组全因死亡率风险显著降低(RR = 0.72,95%CI:0.60 - 0.87),心血管死亡率风险显著降低(RR = 0.52,95%CI:0.29 - 0.92)。然而,因心力衰竭住院的风险无显著差异(RR = 0.85,95%CI:0.70 - 1.04)。此外,与非Met组相比,Met组NT-proBNP水平有显著改善(WMD = -132.91,95%CI:-173.03,-92.79)。在左心室射血分数和左心室舒张末期内径水平的改善方面,两组间未观察到统计学显著差异。

结论

在T2DM合并CHF患者中,使用Met可降低全因死亡率和心血管相关死亡率。此外,它可改善CHF患者的心功能,而不会增加因心力衰竭住院的风险,证实了其安全性和潜在益处。

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