Panda Prem S, Mohapatra Ipsa, Padhee Sourav, Debata Ipsita, Pradhan Somen K, Mukhopadhyay Amita, J Tejas
Community Medicine, Kalinga Institute of Medical Sciences, Bhubaneswar, IND.
Biostatistics, KPMG India, Mumbai, IND.
Cureus. 2025 Apr 7;17(4):e81833. doi: 10.7759/cureus.81833. eCollection 2025 Apr.
Despite pharmacological and lifestyle changes, hyperglycemia management in type 2 diabetes mellitus patients, combined with a risk for cardio-renal problems, continues to present a significant challenge for doctors. Linagliptin has been found to have a renoprotective effect in diabetic nephropathy patients in recent studies. This systematic review and meta-analysis (SRMA) was conducted to synthesize available information so as to better understand if linagliptin has a renoprotective effect in type 2 diabetes mellitus patients with nephropathy. Three databases were searched from January 2013 to December 2022 to identify all published studies reporting "linagliptin's effect in patients with diabetic nephropathy". Owing to the heterogeneity of the included studies, the authors have employed a random-effects model to examine the data in this meta-analysis. Standardized mean differences (SMD) for continuous outcomes were used to compute effect sizes. The final analysis included five studies. The change in estimated glomerular filtration rate (eGFR) did not show a statistically significant difference between the group on linagliptin and the other group on placebo, at baseline (mean difference = 1.19, p = 0.28), after three months of intervention in the selected three studies (mean difference = 0.51, p = 0.85), and after six months of intervention in the selected two studies (mean difference = 0.72, p = 0.70). The study found that linagliptin did not have a significant renoprotective effect in patients with type 2 diabetes, indicating no substantial benefit in slowing kidney disease progression. For diabetes patients with chronic renal disease, linagliptin may be a helpful renoprotective treatment choice, but in the future, more robust and longer-duration research is warranted to establish the inference.
尽管采取了药物治疗和生活方式改变措施，但2型糖尿病患者的高血糖管理，再加上存在心肾问题风险，对医生来说仍然是一项重大挑战。最近的研究发现，利格列汀对糖尿病肾病患者具有肾脏保护作用。进行这项系统评价和荟萃分析（SRMA）是为了综合现有信息，以便更好地了解利格列汀对2型糖尿病肾病患者是否具有肾脏保护作用。检索了2013年1月至2022年12月的三个数据库，以确定所有报告“利格列汀对糖尿病肾病患者的影响”的已发表研究。由于纳入研究的异质性，作者在这项荟萃分析中采用随机效应模型来检验数据。连续结局的标准化均数差（SMD）用于计算效应量。最终分析纳入了五项研究。在基线时（平均差=1.19，p=0.28），在所选三项研究中干预三个月后（平均差=0.51，p=0.85），以及在所选两项研究中干预六个月后（平均差=0.72，p=0.70），利格列汀组与安慰剂组之间估计肾小球滤过率（eGFR）的变化未显示出统计学上的显著差异。该研究发现，利格列汀对2型糖尿病患者没有显著的肾脏保护作用，表明在减缓肾病进展方面没有实质性益处。对于患有慢性肾病的糖尿病患者，利格列汀可能是一种有益的肾脏保护治疗选择，但未来需要更有力、持续时间更长的研究来证实这一推断。
