Wang Feng, Xu Guangzhong, Feng Wei, Qu Gengbao, Li Pengyu, Li Kai
Department of General Surgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
Department of General Practice, Beijing Tongren Hospital, Capital Medical University, Beijing, China.
Eur J Med Res. 2025 Jul 22;30(1):652. doi: 10.1186/s40001-025-02801-2.
Emerging evidence suggested that liraglutide possessed the potential to improve the albumin-to-creatinine ratio (ACR) in patients with type 2 diabetes mellitus (T2DM). This study aimed to ascertain the impact of liraglutide on ACR in T2DM.
PubMed, Embase, the Cochrane Library, WanFang and CNKI were searched for randomized controlled trials (RCTs) from inception to November 30, 2024 (PROSPERO: CRD52025336785). The data were pooled using fixed- or random-effects models based on the heterogeneity. Sensitivity analyses and publication bias assessments were performed.
Seven RCTs involving 473 participants were included. Liraglutide significantly reduced ACR (WMD: - 11.76 mg/g, 95% CI, - 21.71 to - 1.81, I = 75%, P = 0.02) compared to controls (placebo or active drugs). Subgroup analysis revealed significant ACR reductions in patients with HbA1c > 8.0%, follow-up > 12 weeks, and age < 60 years. Meta regression indicated that heterogeneity was not influenced by sample size, HbA1c, baseline ACR, treatment duration, or liraglutide dosage (P = 0.92; 95% CI, - 322.34 to 340.66). The results were stable based in sensitivity analysis, and no publication bias was detected (Begg's P = 0.46; Egger's P = 0.57).
Liraglutide significantly reduced ACR in T2DM, particularly in patients with poor glycemic control, longer treatment duration, and younger age. Future studies with extended follow-up are needed to confirm its renoprotective benefits.
新出现的证据表明，利拉鲁肽具有改善2型糖尿病（T2DM）患者白蛋白与肌酐比值（ACR）的潜力。本研究旨在确定利拉鲁肽对T2DM患者ACR的影响。
检索了PubMed、Embase、Cochrane图书馆、万方和知网中从建库至2024年11月30日的随机对照试验（RCT）（国际前瞻性系统评价注册库：CRD52025336785）。根据异质性，使用固定效应或随机效应模型汇总数据。进行了敏感性分析和发表偏倚评估。
纳入了7项涉及473名参与者的RCT。与对照组（安慰剂或活性药物）相比，利拉鲁肽显著降低了ACR（加权均数差：-11.76mg/g，95%置信区间，-21.71至-1.81，I² = 75%，P = 0.02）。亚组分析显示，糖化血红蛋白（HbA1c）>8.0%、随访>12周和年龄<60岁的患者ACR显著降低。Meta回归表明，异质性不受样本量、HbA1c、基线ACR、治疗持续时间或利拉鲁肽剂量的影响（P = 0.92；95%置信区间，-322.34至340.66）。基于敏感性分析，结果稳定，未检测到发表偏倚（Begg检验P = 0.46；Egger检验P = 0.57）。
利拉鲁肽显著降低了T2DM患者的ACR，尤其是血糖控制不佳、治疗持续时间较长和年龄较轻的患者。需要进行更长时间随访的未来研究来证实其肾脏保护益处。
