Vargas-Ramírez Carlos U, Posadas-Posadas Víctor, Ochoa-Précoma Renata, Porchia Leonardo M, Pérez-Fuentes Ricardo, Gonzalez-Mejia M Elba
Facultad de Medicina, Benemérita Universidad Autónoma de Puebla, 13 Sur 2901 Colonia Volcanes, 72420 Puebla, Puebla México.
Diabetol Int. 2024 Oct 15;16(1):65-77. doi: 10.1007/s13340-024-00765-y. eCollection 2025 Jan.
Sodium-glucose co-transporter-2 inhibitors (SGLT2i) have been shown to reduce visceral (VAT) and subcutaneous (SAT) adipose tissue. Although many systematic reviews have examined SGLT2i's effect on VAT and SAT, a focus analysis of dapagliflozin, one of the more commonly prescribe SGLT2i, has yet to been done. This study aims to determine the effect of dapagliflozin on reducing VAT and SAT in patients with chronic disease.
SCOPUS, PubMed, EBSCO, and LILACS databases were searched until December 26, 2023. Heterogeneity was determined using Cochran's test and quantified using the inconsistency index. The random-effects model was used to calculate the pooled standardize difference in means (SDM) and 95% confidence intervals (95% CI). Duval and Tweedie trim and fill (DT), Egger's test, and Beggs-Muzamar's test were used to assess publication bias. PROSPERO: CRD42023426208.
Twelve reports were included (treated = 299 and controls = 301). Overall, dapagliflozin treatment reduced VAT (SDM = - 0.406, 95% CI: - 0.526 to - 0.286, < 0.001) and SAT (SDM = - 0.439, 95% CI: - 0.601 to - 0.278, < 0.001). These results were stable as determined with a sensitivity analysis; however, there was potential publication bias. Two and three imputed studies were determined by the DT method for VAT and SAT, respectively. When stratified by pathology (obesity, T2D, and T2D/NAFLD), dapagliflozin treatment decreased VAT and SAT for all conditions. However, for specifically SAT, only when compared between T2D and T2D/NAFLD, T2D/NAFLD was associated with a twofold decrease ( = 0.003).
Treatment with dapagliflozin resulted in a significant reduction in VAT and SAT in patients with obesity, T2D, or T2D/NAFLD.
The online version contains supplementary material available at 10.1007/s13340-024-00765-y.
钠-葡萄糖协同转运蛋白2抑制剂（SGLT2i）已被证明可减少内脏脂肪组织（VAT）和皮下脂肪组织（SAT）。尽管许多系统评价研究了SGLT2i对VAT和SAT的影响，但对于更常用的SGLT2i之一达格列净，尚未进行重点分析。本研究旨在确定达格列净对减少慢性病患者VAT和SAT的作用。
检索SCOPUS、PubMed、EBSCO和LILACS数据库至2023年12月26日。使用Cochran检验确定异质性，并使用不一致指数进行量化。采用随机效应模型计算合并的标准化均值差（SDM）和95%置信区间（95%CI）。使用Duval和Tweedie修剪和填充法（DT）、Egger检验和Beggs-Muzamar检验评估发表偏倚。国际前瞻性系统评价注册库（PROSPERO）注册号：CRD42023426208。
纳入12篇报告（治疗组=299例，对照组=301例）。总体而言，达格列净治疗可减少VAT（SDM=-0.406，95%CI：-0.526至-0.286，P<0.001）和SAT（SDM=-0.439，95%CI：-0.601至-0.278，P<0.001）。敏感性分析表明这些结果是稳定的；然而，存在潜在的发表偏倚。DT法分别确定了2项和3项针对VAT和SAT的插补研究。按病理类型（肥胖、2型糖尿病和2型糖尿病/非酒精性脂肪性肝病）分层时，达格列净治疗在所有情况下均可减少VAT和SAT。然而，对于SAT，仅在2型糖尿病和2型糖尿病/非酒精性脂肪性肝病之间比较时，2型糖尿病/非酒精性脂肪性肝病组的SAT减少幅度是2倍（P=0.003）。
达格列净治疗可使肥胖、2型糖尿病或2型糖尿病/非酒精性脂肪性肝病患者的VAT和SAT显著减少。
在线版本包含可在10.1007/s13340-024-00765-y获取的补充材料。
