利拉鲁肽对成人 2 型糖尿病患者 C 反应蛋白 (CRP) 的疗效和安全性：对对照试验进行GRADE评估的系统综述和剂量反应荟萃分析

IF 2.4 Q3 NUTRITION & DIETETICS PharmaNutrition Pub Date : 2024-09-18 DOI:10.1016/j.phanu.2024.100409

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引用次数: 0

摘要

背景利拉鲁肽（LRG）是胰高血糖素样肽-1的类似物，对控制糖尿病患者的血糖有好处。然而，不同研究对利拉鲁肽对C反应蛋白（CRP）的影响存在争议。因此，本研究旨在探讨利拉鲁肽对成人 2 型糖尿病（T2DM）患者 CRP 的影响。方法截至 2024 年 3 月，在 Web of Science、PubMed 和 Scopus 电子数据库中检索了相关研究。使用随机效应模型计算95%置信区间（CI）和平均差异。采用标准方法评估剂量反应、元回归、敏感性和发表偏倚。结果最终，在回顾了9项符合条件的研究，共10个研究臂，包括1494名参与者后，观察到LRG治疗后CRP水平显著下降（WMD = -0.692 mg/L，95 % CI：-1.01，-0.37，P<0.001）。根据亚组结果，LRG对肥胖患者（体重指数≥30）、高质量研究、剂量>1.6 mg/d、持续时间≥24周的疗效更好。LRG剂量与CRP水平之间存在线性（P<0.001）和非线性（P剂量-反应=0.009）剂量-反应关系。结论LRG对患有T2DM的成人，尤其是肥胖患者的CRP水平有益处。

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Efficacy and safety of liraglutide on C-reactive protein (CRP) in adults with type 2 diabetes: A GRADE-assessed systematic review and dose-response meta-analysis of controlled trials

Background

Liraglutide (LRG) is an analog of glucagon-like-peptide-1 which has beneficial effects on controlling glycemic in diabetes patients. However, the effect of liraglutide on the C-reactive protein (CRP) was controversial in different studies. So, this study aimed to investigate the effect of LRG on CRP in adults with type 2 diabetes (T2DM).

Methods

Through March 2024, Web of Science, PubMed, and Scopus electronic databases were searched for pertinent studies. Calculation of 95 % confidence intervals (CIs) and mean differences was done using random effects model. Standard methods assessed dose-response, meta-regression, sensitivity, and publication bias. GRADE (Grading of Recommendations Assessment, Development, and Evaluation) was used to calculate evidence certainty.

Results

Finally, after reviewing 9 eligible studies with 10 arms including 1494 participants, a significant decrease in CRP levels was observed after treatment with LRG (WMD = −0.692 mg/L, 95 % CI: −1.01, −0.37, P<0.001). According to the results of the subgroup, LRG had greater effects in obese patients (Body mass index ≥30), high-quality studies, dosages >1.6 mg/d and durations ≥24 weeks. Linear (P<0.001) and non-linear (P _{dose-response} =0.009) dose-response associations were observed between LRG dosages and CRP levels. According to the GRADE, evidence for CRP was high.