背景:纤维蛋白广泛用于治疗血脂异常和相关的代谢异常;然而,它们对脂肪因子的影响尚不清楚。
目的:这项临床试验的荟萃分析旨在评估贝特类药物对循环脂肪因子水平的影响。
方法:仅在PubMed-Medline的搜索中纳入了研究贝特治疗对循环脂肪因子水平的影响/效果的随机对照试验,Scopus,ClinicalTrials.gov,WebofScience,和谷歌学者数据库。使用随机效应模型和通用逆方差方法进行荟萃分析。敏感性分析采用留一法进行。
结果:这项对22项临床试验的荟萃分析显示,瘦素水平显着降低(WMD:-1.58ng/mL,95%CI:-2.96,-0.20,p=0.02,I2=0%),纤溶酶原激活物抑制剂-1(PAI-1)(WMD:-13.86ng/mL,95%CI:-26.70,-1.03,p=0.03,I2=99%),和内脂素(WMD:-1.52ng/mL,95%CI:-2.49,-0.56,p=0.002,I2=0%)贝特治疗后;对脂联素无明显影响(WMD:-0.69µg/ml,95%CI:-1.40,0.02,p=0.06,I2=83%)和抵抗素(WMD:-2.27ng/mL,95%CI:-7.11,2.57,p=0.36,I2=0%)。敏感性分析仅对visfatin,虽然效应大小对瘦素的一只手臂敏感,四是脂联素,和两个用于PAI-1。
结论:这项荟萃分析显示,贝特类药物治疗可显着改善脂肪因子水平,降低瘦素,PAI-1和visfatin,提示通过对脂肪组织进行贝特治疗的潜在额外临床治疗益处。
BACKGROUND: Fibrates are widely used in the treatment of dyslipidemia and associated metabolic abnormalities; however, their effects on adipokines are unclear.
OBJECTIVE: This meta-analysis of clinical trials aimed to evaluate the effect of
fibrates on circulating adipokine levels.
METHODS: Only randomized controlled trials investigating the impact/effect of fibrate treatment on circulating adipokine levels were included from searches in PubMed-Medline, SCOPUS, ClinicalTrials.gov, Web of Science, and Google Scholar databases. A random effects model and the generic inverse variance method were used for the meta-analysis. Sensitivity analysis was conducted using the leave-one-out method.
RESULTS: This meta-analysis of 22 clinical trials showed a significant reduction on/in leptin (WMD: -1.58 ng/mL, 95% CI: -2.96, -0.20, p = 0.02, I2 = 0%), plasminogen activator inhibitor-1 (PAI-1) (WMD: -13.86 ng/mL, 95% CI: -26.70, -1.03, p = 0.03, I2 = 99%), and visfatin (WMD: -1.52 ng/mL, 95% CI: -2.49, -0.56, p = 0.002, I2 = 0%) after fibrate therapy; no significant effect was observed on adiponectin (WMD: -0.69 µg/ml, 95% CI: -1.40, 0.02, p = 0.06, I2 = 83%) and resistin (WMD: -2.27 ng/mL, 95% CI: -7.11, 2.57, p = 0.36, I2 = 0%). The sensitivity analysis was robust only for visfatin, while the effect size was sensitive to one arm for leptin, four for adiponectin, and two for PAI-1.
CONCLUSIONS: This meta-analysis showed that fibrate treatment significantly improves adipokine levels with a decrease in leptin, PAI-1, and visfatin, suggesting potential additional clinical therapeutic benefits through/of fibrate treatment on adipose tissue.