摘要
目的系统评价奥利司他治疗超重或肥胖2型糖尿病(T2DM)的疗效和安全性。方法计算机检索PubMed、EMbase、The Cochrane Library、WanFang Data、CNKI和VIP数据库,搜集关于奥利司他治疗超重或肥胖T2DM的随机对照试验(RCT),检索时限均从建库至2022年6月29日。由2名研究员独立筛选文献、提取资料并评价纳入研究的偏倚风险后,采用Stata 16.0软件进行Meta分析。结果共纳入24个RCT,包括3702例患者。Meta分析结果显示:与对照组相比,奥利司他组空腹血糖[WMD=1.04,95%CI(0.80,1.29),P<0.001]、餐后2小时血糖[WMD=1.17,95%CI(0.78,1.56),P<0.001]和糖化血红蛋白[WMD=0.84,95%CI(0.51,1.17),P<0.001]降低更显著,总胆固醇、甘油三酯、低密度脂蛋白、体重和体质量指数的降幅也更大(P<0.001)。奥利司他组的腹痛、排便增多等不良反应发生率较对照组高,但不良反应均较轻,多数能自愈。结论当前证据表明,奥利司他可有效和安全地降低超重或肥胖T2DM患者体重,改善血糖和血脂指标。受纳入研究数量和质量的限制,上述结论尚待更多高质量研究予以验证。
Objective To systematically review the efficacy and safety of orlistat in the treatment of overweight and obese type 2 diabetes mellitus(T2DM).Methods PubMed,EMbase,The Cochrane Library,CNKI,WanFang Data and VIP databases were electronically searched to collect randomized controlled trials(RCTs)on the efficacy and safety of orlistat in the treatment of overweight and obese T2DM patients from inception to June 29th,2022.Two reviewers independently screened the literature,extracted data and assessed the risk of bias of the included studies;then,metaanalysis was performed by using Stata 16.0 software.Results A total of 24 RCTs involving 3702 patients were included.The results of meta-analysis showed that compared with control group,orlistat group could significantly decrease the levels of fasting blood glucose(WMD=1.04,95%CI 0.80 to 1.29,P<0.001),2h postprandial blood glucose(WMD=1.17,95%CI 0.78 to 1.56,P<0.001)and hemoglobin A1c(WMD=0.84,95%CI 0.51 to 1.17,P<0.001),and the levels of total cholesterol,triglyceride,low density lipoprotein,body weight and body mass index also significantly decreased(P<0.001).The incidence of adverse events such as increased defecation and abdominal pain of orlistat was slightly higher than that of control group;however,most could be self-healing.Conclusion Current evidence shows that orlistat can effectively and safely improve blood sugar,lipid index in overweight and obese T2DM patients.Due to limited quality and quantity of the included studies,more high-quality studies are needed to verify the above conclusion.
作者
朱洁云
朱良峰
潘冬赞
王俏燕
黄春莉
陆钊
沈印
ZHU Jieyun;ZHU Liangfeng;PAN Dongzan;WANG Qiaoyan;HUANG Chunli;LU Zhao;SHEN Yin(International Medical Services,the People's Hospital of Guangxi Zhuang Autonomous Region,Nanning 530021,P.R.China)
出处
《中国循证医学杂志》
CSCD
北大核心
2022年第9期1020-1026,共7页
Chinese Journal of Evidence-based Medicine
