摘要
目的系统评价长效胰高血糖素样肽-1受体激动剂司美格鲁肽治疗超重或肥胖症的非糖尿病患者的有效性与安全性。方法计算机检索PubMed、Embase、Cochrane Libarary、Medline、Web of Science、Clinical Trails.gov、知网、维普、万方、中国生物医学数据库。检索时限为自建库起至2022年6月1日,搜集关于司美格鲁肽治疗超重或肥胖症的非糖尿病成人患者的随机对照试验(RCT),对纳入的文献使用Cochrane协作网推荐的RCT偏倚风险评估工具及修改后的Jadad评分量表进行偏倚风险评估和质量评分后,采用Rev Man 5.3软件进行Meta分析。结果共纳入8项RCT,共4005例超重或肥胖的非糖尿病成人患者。Meta分析结果显示司美格鲁肽在降低体重(MD:-10.98 kg,95%CI:-12.66~-9.30,P<0.01)、BMI(MD:-3.27 kg/m2,95%CI:-5.31~-1.23,P<0.01)、腰围(MD:-8.43 cm,95%CI:-11.22~-5.63,P<0.01)方面显著优于安慰剂,且司美格鲁肽组体重下降大于5%、10%、15%的患者比例更高,同时司美格鲁肽在降低空腹血糖、糖化血红蛋白、血脂(TC、HDL、LDL、VLDL、FFA、TG)、收缩压及舒张压上优于安慰剂对照组,组间差异有统计学意义(均P<0.05)。而司美格鲁肽组在低血糖、恶心、呕吐、腹痛、头痛、注射部位不良反应、急性胰腺炎、急性肾功能衰竭、恶性肿瘤等不良反应事件的发生率与安慰剂组相似,差异无统计学意义(均P>0.05)。结论1周1次皮下注射司美格鲁肽可显著降低超重或肥胖症的非糖尿病成人患者的体重、BMI及腰围,同时低血糖、恶心、呕吐等不良反应发生率低,为临床治疗超重或肥胖症的非糖尿病成人患者提供了新的选择。
Objective To systematically evaluate the efficacy and safety of long-acting glucagon-like peptide-1 receptor agonist Semaglutide among overweight or obese adults without diabetes.Methods We searched PubMed,Embase,Cochrane Libarary,Medline,Web of Science,Clinical Trails.gov,CNKI,VIP,Wanfang and CBM databases for randomized controlled trials(RCTs)that compared Semaglutide with placebo in overweight or obese adults from inception to June 1st,2022.After literature screening,data extraction and quality assessment of the included literature,we used Rev Man 5.3 software for meta-analysis.Results A total of 8 publications with 4005 participants were included in this meta-analysis.This meta-analysis revealed that Semaglutide could significantly reduce body weight(MD:-10.98 kg,95%CI:-12.66~-9.30,P<0.01),BMI(MD:-3.27 kg/m~2,95%CI:-5.31~-1.23,P<0.01),waist circumference(MD:-8.43 cm,95%CI:-11.22~-5.63,P<0.01)compared with placebo.Moreover,the proportions of patients whose weight loss was over 5%,10%and 15%were greater after administration of Semaglutide.In terms of safety,there was no significant difference between Semaglutide group and placebo group in hypoglycemia,nausea,vomiting,abdominal pain,headache,injection-site reaction,acute pancreatitis,acute renal failure and malignant neoplasm occurrence(all P>0.05).Conclusion Semaglutide could effectively reduce the body weight of overweight or obese adults.Semaglutide could be a new option for treatment of overweight or obese adults without diabetes.
作者
毕娅琼
张欢
李裕明
Bi Yaqiong;Zhang Huan;Li Yuming(Department of Endocrinology,Union Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430022,China)
出处
《华中科技大学学报（医学版）》
CAS
CSCD
北大核心
2023年第1期88-96,共9页
Acta Medicinae Universitatis Scientiae et Technologiae Huazhong
