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Abstract：
This systematic review and meta-analysis determine how frequently and how seriously gastrointestinal manifestations affect people with type 2 diabetes mellitus on tirzepatide. Tirzepatide is a recently developed drug that attempts to enhance type 2 diabetics\' ability to regulate their blood sugar levels and promote weight reduction. Despite its potential benefits, clinical trials have revealed that the medication may lead to gastrointestinal side effects, including nausea, vomiting, decreased appetite, dyspepsia, constipation, and diarrhea. These side effects may negatively affect the drug\'s efficacy and patient tolerance. A comprehensive search of electronic databases such as PubMed, Web of Science, and Cochrane Library, was conducted to find pertinent studies reporting on the frequency and severity of gastrointestinal symptoms in type 2 diabetes patients receiving tirzepatide. This systematic review follows the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines. Study selection, data extraction, and quality assessment were performed. Six randomized controlled trials with a total of 4,586 patients were included. Most patients received tirzepatide to regulate their blood sugar levels and promote weight reduction, and the comparators were placebo, glucagon-like peptide one receptor agonists drugs, and insulin degludec. The dose of tirzepatide was 5mg, 10mg, and 15mg weekly. The incidence rate of nausea in patients who receive tirzepatide was 20.43%, while the incidence rate in the comparators was 10.47%, and it was significantly higher in the tirzepatide arm than in the comparators (RR, 2.90; 95% CI, 1.89 to 4.44; P ≤ 0.00001). The incidence rate of vomiting in patients who receive tirzepatide was 9.05%, while the rate in the comparators was 4.86%, and it was significantly higher in the tirzepatide arm than in the comparators (RR, 2.69; 95% CI, 1.67 to 4.36; P ≤ 0.0001). The incidence rate of constipation in patients who receive tirzepatide was 2.54%, while the rate in the comparators was 0.856%, and it was significantly higher in the tirzepatide arm than in the comparators (RR, 3.08; 95% CI, 1.83 to 5.20; P ≤ 0.0001). The incidence rate of decreased appetite in patients who receive tirzepatide was 9.64%, while the rate in the comparators was 2.88%, and it was significantly higher in the tirzepatide arm than in the comparators (RR, 5.04; 95% CI, 3.01 to 8.45; P ≤ 0.00001). The incidence rate of diarrhea in patients who receive tirzepatide was 16.24%, while the rate in the comparators was 8.63%, and it was significantly higher in the tirzepatide arm than in the comparators (RR, 2.07; 95% CI, 1.60 to 2.68; P ≤ 0.00001). The incidence rate of dyspepsia in patients who receive tirzepatide was 7.13%, while the rate in the comparators was 3.31%, and it was significantly higher in the tirzepatide arm than in the comparators (RR, 2.52; 95% CI, 1.58 to 4.01; P ≤ 0.0001). Tirzepatide usage is linked to a significant prevalence of gastrointestinal symptoms, including nausea, constipation, decreased appetite, dyspepsia, diarrhea, and vomiting, in people with type 2 diabetes. These findings may influence clinical decision-making and patient counseling on the use of tirzepatide and have significant implications for the medication\'s tolerance and efficacy. To find ways to reduce these negative effects and improve therapy for type 2 diabetes patients, more research is required.
摘要：
本系统评价和荟萃分析确定了胃肠道表现对2型糖尿病患者的影响的频率和严重程度。Tirzepatide是最近开发的一种药物，试图增强2型糖尿病患者调节血糖水平和促进体重减轻的能力。尽管有潜在的好处,临床试验表明，这种药物可能导致胃肠道副作用，包括恶心,呕吐,食欲下降,消化不良,便秘,和腹泻。这些副作用可能会对药物的疗效和患者的耐受性产生负面影响。对PubMed等电子数据库进行全面搜索，WebofScience,和Cochrane图书馆,我们进行了相关的研究,这些研究报告了接受替瑞哌肽治疗的2型糖尿病患者胃肠道症状的频率和严重程度.本系统评价遵循系统评价和荟萃分析（PRISMA）指南的首选报告项目。研究选择，数据提取,并进行质量评估。纳入6项随机对照试验，共4,586例患者。大多数患者接受替利平肽来调节他们的血糖水平并促进体重减轻，比较者是安慰剂，胰高血糖素样肽一受体激动剂药物，和胰岛素degludec。替拉肽的剂量为5mg，10mg,每周15mg。接受替利平肽治疗的患者恶心发生率为20.43%,而比较者的发病率为10.47%，并且在tirzepatide组中明显高于比较组（RR，2.90；95%CI，1.89~4.44；P≤0.00001）。接受替利平肽治疗的患者呕吐发生率为9.05%,而比较者的比率为4.86%，并且在tirzepatide组中明显高于比较组（RR，2.69；95%CI，1.67~4.36；P≤0.0001）。接受替利平肽治疗的患者便秘发生率为2.54%,而比较者的比率为0.856%，并且在tirzepatide组中明显高于比较组（RR，3.08；95%CI，1.83~5.20；P≤0.0001）。接受替拉肽治疗的患者食欲下降的发生率为9.64％，而比较者的比率为2.88%，并且在tirzepatide组中明显高于比较组（RR，5.04；95%CI，3.01~8.45；P≤0.00001）。接受替利平肽治疗的患者腹泻发生率为16.24%,而比较者的比率为8.63%，并且在tirzepatide组中明显高于比较组（RR，2.07；95%CI，1.60~2.68；P≤0.00001）。接受替利平肽治疗的患者消化不良发生率为7.13%,而比较者的比率为3.31%，并且在tirzepatide组中明显高于比较组（RR，2.52；95%CI，1.58至4.01；P≤0.0001）。Tirzepatide的使用与胃肠道症状的显着流行有关，包括恶心,便秘,食欲下降,消化不良,腹泻,呕吐,2型糖尿病患者。这些发现可能会影响临床决策和患者对使用替利哌肽的咨询，并对药物的耐受性和疗效具有重要意义。寻找减少这些负面影响并改善2型糖尿病患者的治疗方法，需要更多的研究。
