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BMJ：二肽基肽酶抑制剂和2型糖尿病患者的心衰风险

2016-02-18 Mechront 译 MedSci原创

二肽基肽酶抑制剂心衰糖尿病
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研究者检索了Medline、Embase等相关数据库中关于二肽基肽酶-4(DPP-4)抑制剂和2型糖尿病患者的心衰风险的随机对照试验、非随机对照试验、队列研究和病例对照研究，对其进行了系统回顾和荟萃分析。最终纳入了43项试验（n=68 775）和12项观察性研究（9项队列研究，3项病例对照研究，n=1 777 358）。合并38项低质量证据的试验报道了DPP-4抑制剂组和对照组有相似的心衰风险（4

研究者检索了Medline、Embase等相关数据库中关于二肽基肽酶-4(DPP-4)抑制剂和2型糖尿病患者的心衰风险的随机对照试验、非随机对照试验、队列研究和病例对照研究，对其进行了系统回顾和荟萃分析。

最终纳入了43项试验（n=68 775）和12项观察性研究（9项队列研究，3项病例对照研究，n=1 777 358）。合并38项低质量证据的试验报道了DPP-4抑制剂组和对照组有相似的心衰风险（42/15 701 v 33/12 591；OR=0.97 (95% CI 0.61-1.56)；RD -2（-19~+28）/1000人（2型糖尿病患者，超过5年））。观察性研究提供的效果估计与试验结果相一致，但具有非常低的质量证据。合并5项中等质量证据的试验后显示，DPP-4抑制剂组与对照组相比，会增加心衰住院风险 (622/18 554 v 552/18 474; 1.13 (1.00- 1.26); +8  (+0 ~ +16 ))。合并非常低质量证据的观察性研究后显示相似结果，DPP-4抑制剂会增加心衰住院风险（aOR= 1.41, 95% CI 0.95 - 2.09）。

该系统回顾和荟萃分析的结果表明，鉴于随访时间短、证据质量低，当前关于DPP-4抑制剂是否会增加2型糖尿病患者心衰风险的结论仍不明确。不管是随机对照试验还是观察性研究，均指出DPP-4抑制剂会增加存在心血管疾病或有多个心血管危险因素患者的心衰住院风险。

原始出处：

Ling Li, Sheyu Li, et al.Dipeptidyl peptidase-4 inhibitors and risk of heart failure in type 2 diabetes: systematic review and meta-analysis of randomised and observational studies.BMJ 2016; 352 doi: http://dx.doi.org/10.1136/bmj.i610


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    2016-07-18 jklm09

    #抑制剂#

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    2016-11-18 gaoxiaoe

    #BMJ#

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    2016-02-20 aids213

    #2型糖尿病患者#

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    2016-02-20 ms3994565386320060

    #心衰风险#

    0

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    2016-02-20 xue8604

    #糖尿病患者#

    0