Wen Zhige, Sun Wenjie, Wang Haoshuo, Chang Ruiting, Wang Jialing, Song Changheng, Zhang Shan, Ni Qing, An Xuedong
Guang'anmen Hospital of China Academy of Chinese Medical Sciences, China.
Guang'anmen Hospital of China Academy of Chinese Medical Sciences, China.
Diabetes Res Clin Pract. 2025 Apr;222:111999. doi: 10.1016/j.diabres.2025.111999. Epub 2025 Jan 17.
To evaluate the effectiveness and safety of different Glucagon-like peptide-1 receptor agonists (GLP-1RAs) in treating type 2 diabetes mellitus (T2DM) with overweight/obesity using a systematic review and network meta-analysis.
We searched PubMed, Embase, Cochrane Library, and Web of Science up to December 20, 2024, for randomized controlled trials (RCTs) involving T2DM patients with overweight/obesity treated with GLP-1RAs, with the control group receiving either a placebo or another GLP-1RA. We conducted a network meta-analysis assessed evidence using CINeMA.
A total of 4548 articles were retrieved, and 41 RCTs were included, comprising 15,126 patients and 13 different GLP-1RAs. Tirzepatide showed superior effects in lowering blood glucose (Compared with placebo, increased glycated hemoglobin: -1.64 (-1.94, -1.35), increased fasting blood glucose: -2.10 (-2.95, -1.25)) and weight loss (Compared with placebo, increased weight: -9.89 (-11.29, -8.49), rincreased BMI: -3.85 (-4.71, -2.99)). However, clinical efficacy of GLP-1RAs in lipid levels, blood pressure, and pancreatic function was not widely observed. Adverse reactions were significant with GLP-1RAs, but overall acceptable.
GLP-1RAs demonstrate efficacy and safety in T2DM patients with overweight/obesity, with certain advantages over other drugs. However, due to limitations in the number and quality of included studies, conclusions should be interpreted with caution.
通过系统评价和网状Meta分析，评估不同胰高血糖素样肽-1受体激动剂（GLP-1RAs）治疗超重/肥胖2型糖尿病（T2DM）的有效性和安全性。
检索截至2024年12月20日的PubMed、Embase、Cochrane图书馆和Web of Science，查找涉及接受GLP-1RAs治疗的超重/肥胖T2DM患者的随机对照试验（RCTs），对照组接受安慰剂或另一种GLP-1RAs。我们使用CINeMA进行网状Meta分析并评估证据。
共检索到4548篇文章，纳入41项RCTs，包括15126例患者和13种不同的GLP-1RAs。替尔泊肽在降低血糖（与安慰剂相比，糖化血红蛋白升高：-1.64（-1.94，-1.35），空腹血糖升高：-2.10（-2.95，-1.25））和体重减轻（与安慰剂相比，体重增加：-9.89（-11.29，-8.49），BMI增加：-3.85（-4.71，-2.99））方面显示出更好的效果。然而，GLP-1RAs在血脂、血压和胰腺功能方面的临床疗效未被广泛观察到。GLP-1RAs的不良反应显著，但总体可接受。
GLP-1RAs在超重/肥胖的T2DM患者中显示出有效性和安全性，相对于其他药物具有一定优势。然而，由于纳入研究的数量和质量存在局限性，结论应谨慎解读。
