恩格列净对2型糖尿病患者血清尿酸水平的影响：一项系统评价和荟萃分析。
Effects of empagliflozin on serum uric acid level of patients with type 2 diabetes mellitus: a systematic review and meta-analysis.
作者信息
You Yinyuan, Zhao Yu, Chen Mujuan, Pan Ying, Luo Zhenhui
机构信息
Department of Pharmacy, Baoan Central Hospital of Shenzhen, No.3, Xiyuan Street, Bao' an District, Shenzhen, Shenzhen, 518102, China.
出版信息
Diabetol Metab Syndr. 2023 Oct 16;15(1):202. doi: 10.1186/s13098-023-01182-y.
BACKGROUND
Serum uric acid levels are higher in patients with type 2 diabetes and prediabetes compared to healthy individuals, and hyperuricemia causes a significant rate of complications and mortality through heart and kidney diseases. Accordingly, the present systematic review and meta-analysis aimed to investigate the effect of empagliflozin on serum uric acid levels.
MATERIALS AND METHODS
Electronic databases, including PubMed, Scopus, Web of Science, Cochrane, and Google Scholar, were used to search papers until May 22, 2023. Data analysis was conducted by STATA Version 14, and P-value < 0.05 were considered statistically significant.
RESULTS
The results obtained from the combination of 12 studies with 7801 samples of diabetic patients indicated that in the empagliflozin group, the serum uric acid levels of the patients decreased ([standardized mean difference (SMD): - 1.97 (95%CI - 3.39, - 0.55)], Systolic blood pressure (SBP) [SMD: - 2.62 (95%CI - 3.87, - 1.37)] and diastolic blood pressure (DBP) [SMD: - 0.49 (95%CI - 0.68, - 0.29)]). On the other side, empagliflozin treatment did not affect the patients' HbA1c levels ([SMD: - 2.85 (95%CI - 6.14, 0.45)], eGFR [SMD: 0.78 (95%CI - 0.63, 2.18)], creatinine [SMD:0.11 (95%CI - 0.10, 0.31)], LDL [SMD: 0.14 (95%CI - 0.43, 0.71)], and HDL [SMD:1.38 (95%CI - 0.22, 2.99)]). Compared with the placebo, empagliflozin was more effective in reducing the uric acid levels ([SMD: - 1.34 (95%CI - 2.05, - 0.63)], SBP [SMD: - 2.11 (95%CI - 3.89, - 0.33)], and HbA1c [SMD: - 1.04 (95%CI - 1.95, - 0.13)]). Moreover, compared with sitagliptin also, empagliflozin was more effective in reducing uric acid levels ([SMD: - 1 (95%CI - 1.78, - 0.22)], and creatinine [SMD: - 1.60 (95%CI - 2.28, - 0.92)]) and increasing eGFR levels [SMD: 0.99 (95%CI: 0.37, 1.62)] of the patients. Compared with dapagliflozin also, empagliflozin caused a reduction in eGFR level [SMD: - 0.45 (95%CI - 0.82, - 0.08)].
CONCLUSION
Empagliflozin treatment was effective in controlling diabetic patients' hyperuricemia and hypertension.
背景
与健康个体相比，2型糖尿病患者和糖尿病前期患者的血清尿酸水平更高，高尿酸血症通过心脏和肾脏疾病导致显著的并发症发生率和死亡率。因此，本系统评价和荟萃分析旨在研究恩格列净对血清尿酸水平的影响。
材料与方法
使用包括PubMed、Scopus、Web of Science、Cochrane和谷歌学术在内的电子数据库检索截至2023年5月22日的论文。数据分析采用STATA 14版，P值<0.05被认为具有统计学意义。
结果
对12项研究共7801例糖尿病患者样本进行综合分析的结果表明，在恩格列净组中，患者的血清尿酸水平降低（[标准化均数差（SMD）：-1.97（95%CI -3.39，-0.55）]），收缩压（SBP）[SMD：-2.62（95%CI -3.87，-1.37）]和舒张压（DBP）[SMD：-0.49（95%CI -0.68，-0.29）]。另一方面，恩格列净治疗对患者的糖化血红蛋白水平（[SMD：-2.85（95%CI -6.14，0.45）]）、估算肾小球滤过率（eGFR）[SMD：0.78（95%CI -0.63，2.18）]、肌酐[SMD：0.11（95%CI -0.10，0.31）]、低密度脂蛋白（LDL）[SMD：0.14（95%CI -0.43，0.71）]和高密度脂蛋白（HDL）[SMD：1.38（95%CI -0.22，2.99）]无影响。与安慰剂相比，恩格列净在降低尿酸水平（[SMD：-1.34（95%CI -2.05，-0.63）]）、收缩压（[SMD：-2.11（95%CI -3.89，-0.33）]）和糖化血红蛋白（[SMD：-1.04（95%CI -1.95，-0.13）]）方面更有效。此外，与西格列汀相比，恩格列净在降低尿酸水平（[SMD：-1（95%CI -1.78，-0.22）]）和肌酐（[SMD：-1.60（95%CI -2.28，-0.92）]）以及提高患者的估算肾小球滤过率水平[SMD：0.99（95%CI：0.37，1.62）]方面更有效。与达格列净相比，恩格列净导致估算肾小球滤过率水平降低[SMD：-0.45（95%CI -0.82，-0.08）]。
结论
恩格列净治疗对控制糖尿病患者的高尿酸血症和高血压有效。
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