目的:综述二甲双胍在糖尿病患者血管新生中作用的相关文献。
方法:2022年5月至9月进行的系统评价和荟萃分析,包括在Medline上的搜索,ScienceDirect,ProQuest,WebofScience,EBSCOhost和Cochrane图书馆数据库。包括的研究以英语发表,并且是人体研究,血管生成内皮标志物作为接受二甲双胍治疗的2型糖尿病患者的关注结果。内皮标志物,包括血管内皮生长因子,von-Willebrand-factor,纤溶酶原激活物抑制剂-1,可溶性血管粘附分子-1,细胞间粘附分子-1,可溶性内皮选择素,组织纤溶酶原激活剂,尿白蛋白排泄,血小板内皮细胞粘附分子-1和凝血酶激活的纤溶抑制剂,被评估为血管生成结果。使用ReviewManager5.4对数据进行统计分析。
结果:在确定的413项研究中,纳入8项(1.9%);5项(62.5%)随机对照试验,2(25.0%)横截面,和1项(12.5%)队列研究,共有1199名患者。在结果中,von-Willebrandfactor(p=0.01),可溶性血管粘附分子-1(p<0.00001),细胞间粘附分子-1(p=0.0003),可溶性内皮选择素(p=0.007),和组织纤溶酶原激活剂(p<0.00001)在使用随机效应方法的二甲双胍治疗后显示出明显更低的水平。
结论:发现二甲双胍具有改善内皮功能的额外作用。
OBJECTIVE: To review relevant literature regarding the role of metformin in angiogenesis among diabetic patients.
METHODS: The systematic review and meta-analysis conducted from May to September 2022, and comprised search on Medline, ScienceDirect, ProQuest, Web of Science, EBSCOhost and Cochrane Library databases. The studies included were published in the English language and were human studies having angiogenesis endothelial markers as the outcomes of interest among patients of type 2 diabetes mellitus undergoing metformin therapy. Endothelial markers, including vascular endothelial growth factor, von-Willebrand-factor, plasminogen activator inhibitor-1, soluble vascular adhesion molecule- 1, intercellular adhesion molecule-1, soluble endothelialselectin, tissue plasminogen activator, urinary albumin excretion, platelet endothelial cell adhesion molecule-1 and thrombin-activatable fibrinolysis inhibitor, were assessed as angiogenesis outcomes. Data was statistically analysed using Review Manager 5.4.
RESULTS: Of the 413 studies identified, 8(1.9%) were included; 5(62.5%) randomised control trials, 2(25.0%) cross-sectional, and 1(12.5%) cohort studies, with overall 1199 patients. Among the outcomes, von-Willebrandfactor (p=0.01), soluble vascular adhesion molecule-1 (p<0.00001), intercellular adhesion molecule-1 (p=0.0003), soluble endothelial-selectin (p=0.007), and tissue plasminogen activator (p<0.00001) showed significantly lower levels after metformin treatment using the random effect methods.
CONCLUSIONS: Metformin was found to have an additional effect of endothelial function improvement.