背景:与健康个体相比,2型糖尿病和糖尿病前期患者的血清尿酸水平更高,高尿酸血症导致心脏和肾脏疾病的并发症和死亡率很高。因此,本系统综述和荟萃分析旨在研究依帕列净对血清尿酸水平的影响。
方法:电子数据库,包括PubMed,Scopus,WebofScience,科克伦,和谷歌学者,一直用于搜索论文,直到2023年5月22日。通过STATA第14版进行数据分析,P值<0.05被认为具有统计学意义。
结果:从12项研究与7801例糖尿病患者样本的组合获得的结果表明,在依帕列净组,患者的血清尿酸水平降低([标准化平均差(SMD):-1.97(95CI-3.39,-0.55)],收缩压(SBP)[SMD:-2.62(95CI-3.87,-1.37)]和舒张压(DBP)[SMD:-0.49(95CI-0.68,-0.29)])。在另一边,empagliflozin治疗不影响患者的HbA1c水平([SMD:-2.85(95CI-6.14,0.45)],eGFR[SMD:0.78(95CI-0.63,2.18)],肌酐[SMD:0.11(95CI-0.10,0.31)],LDL[SMD:0.14(95CI-0.43,0.71)],和HDL[SMD:1.38(95CI-0.22,2.99)])。与安慰剂相比,empagliflozin更有效地降低尿酸水平([SMD:-1.34(95CI-2.05,-0.63)],SBP[SMD:-2.11(95CI-3.89,-0.33)],和HbA1c[SMD:-1.04(95CI-1.95,-0.13)])。此外,与西格列汀相比,empagliflozin更有效地降低尿酸水平([SMD:-1(95CI-1.78,-0.22)],和肌酐[SMD:-1.60(95CI-2.28,-0.92)])和增加的eGFR水平[SMD:0.99(95CI:0.37,1.62)]的患者。与达格列净相比,empagliflozin导致eGFR水平降低[SMD:-0.45(95CI-0.82,-0.08)]。
结论:Empagliflozin治疗可有效控制糖尿病患者的高尿酸血症和高血压。
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.
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)].
CONCLUSIONS: Empagliflozin treatment was effective in controlling diabetic patients\' hyperuricemia and hypertension.