二甲双胍治疗 2 型糖尿病患者的胃肠道不良事件：系统评价和观察性研究的荟萃回归分析。
Gastrointestinal adverse events of metformin treatment in patients with type 2 diabetes mellitus: a systematic review and meta-analysis with meta-regression of observational studies.
机构信息
Department of Internal Medicine, Diabetology and Nephrology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, 3 May Street, Zabrze, Katowice, 41-800, Poland.
Liverpool Centre for Cardiovascular Science at University of Liverpool, Liverpool John Moores University and Liverpool Heart & Chest Hospital, Liverpool, UK.
出版信息
BMC Endocr Disord. 2024 Sep 30;24(1):206. doi: 10.1186/s12902-024-01727-w.
INTRODUCTION
Metformin is the most prescribed medication for type 2 diabetes mellitus (T2DM); there is a well-established link with the elevated incidence of gastrointestinal (GI) adverse events (AE) limiting its administration or intensification.
OBJECTIVES
The objective of this systematic review and meta-analysis of observational studies was to evaluate the pooled incidence of GI AE related to metformin use in patients with T2DM.
MATERIALS AND METHODS
PUB MED/CINAHL/Web of Science/Scopus were searched from database inception until 29.07.2024 for observational studies in English describing the frequency of GI AE in patients with T2DM treated with metformin. Random-effects meta-analyses were used to derive effect sizes: event rates.
RESULTS
From 7019 publications, we identified 211 potentially eligible full-text articles. Ultimately, 21 observational studies were included in the meta-analysis. The prevalence of GI AE was as follows: diarrhea 6.9% (95% CI: 0.038-0.123), bloating 6,2% (95% CI: 0.020-0.177), abdominal pain 5,3% (95% CI: 0.003-0.529), vomiting 2.4% (95%: CI 0.007-0.075), constipation 1.1% (95%: CI 0.001-0.100). The incidence of bloating (coefficient -4.46; p < 0.001), diarrhea (coefficient -1.17; p = 0.0951) abdominal pain (coefficient -2.80; p = 0.001), constipation (coefficient -5.78; p = 0.0014) and vomiting (coefficient -2.47; p < 0.001) were lower for extended release (XR) metformin than metformin immediate release (IR) formulation.
CONCLUSIONS
This study highlights the prevalence of GI AE in patients receiving metformin, with a diarrhea predominance, followed by bloating, diarrhea, abdominal pain, constipation, and vomiting. The incidence is lower in patients administered with XR metformin.
TRIAL REGISTRATION
https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021289975 , identifier CRD42021289975.
简介
二甲双胍是治疗 2 型糖尿病（T2DM）最常用的药物；已有充分证据表明，其胃肠道（GI）不良事件（AE）发生率升高，限制了其使用或强化治疗。
目的
本系统评价和观察性研究的荟萃分析旨在评估二甲双胍治疗 T2DM 患者相关 GI AE 的发生率。
材料和方法
从数据库建立到 2024 年 7 月 29 日，在 PUB MED/CINAHL/Web of Science/Scopus 上检索了描述接受二甲双胍治疗的 T2DM 患者 GI AE 频率的英文观察性研究。使用随机效应荟萃分析得出效应大小：事件率。
结果
从 7019 篇文献中，我们确定了 211 篇可能符合条件的全文文章。最终，21 项观察性研究被纳入荟萃分析。GI AE 的患病率如下：腹泻 6.9%（95%CI：0.038-0.123），腹胀 6.2%（95%CI：0.020-0.177），腹痛 5.3%（95%CI：0.003-0.529），呕吐 2.4%（95%CI：0.007-0.075），便秘 1.1%（95%CI：0.001-0.100）。与普通释放（XR）二甲双胍相比，释放（XR）二甲双胍的腹胀（系数-4.46；p<0.001）、腹泻（系数-1.17；p=0.0951）、腹痛（系数-2.80；p=0.001）、便秘（系数-5.78；p=0.0014）和呕吐（系数-2.47；p<0.001）发生率较低。
结论
本研究强调了接受二甲双胍治疗的患者中 GI AE 的患病率，以腹泻为主，其次是腹胀、腹泻、腹痛、便秘和呕吐。在接受 XR 二甲双胍治疗的患者中，发病率较低。
试验注册
https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021289975，标识符 CRD42021289975。
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