914 χ2, (P>0.1, I 2 <50%), ; : PubMed EMBASE theco- (P<0.1,I 2 >50%), chranecontroled Trials Register ; : P, type2diabetes nateglinide r

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1 913 2 蔡晓凌罗樱樱韩学尧纪立农 T2DM, 43 HbA1c, α- (AGIs), (SUs) ; FPG, AGIs SUs ;, SUs AGIs T2DM ;,2; doi: /j.issn Meta-analysisoftheeficacyandsafetyofnateglinideinAsiantype2diabetes CAI Xiao-ling,LUO Ying- ying,han Xue-yao,etal.Departmentof Endocrinology & Metabolism,Peking University People s Hospital,Beijing100044,China Corresponding author:ji Li-nong, jiln@bjmu.edu.cn Abstract Objective TocomparetheeficacyandsafetyofnateglinideinAsianT2DM patients. Methods The MEDLINE?,EMBASE? and CENTRAL were searched and qualified studies were included. Results Totaly43qualifiedstudieswereincluded.IntermsofHbA1cdecline,nateglinide treatmentwassuperiortoplacebo (WMD:-0.28%,95%CI:-0.41~ -0.14)orα-glucosidase inhibitors(agis)(wmd:-0.27%,95%ci:-0.53~-0.02),andwascomparablewithrepaglinideor mitiglinideorsulfonylureas (SUs).Intermsoffasting glucoselowering,nateglinidetreatment was comparablewith placebo or AGIs,or SUs or mitiglinide,but wasinferiorto repaglinide (WMD: 0.17mmol/L,95%CI:0.05~0.30).Intermsofpostprandialglucoselowering,nateglinidetreatment wascomparablewith AGIsorrepaglinide,ormitiglinideorSUs.Intermsoffastinginsulinsecretion, nateglinidetreatment wascomparable with placebo orrepaglinideorsus.intermsofbody weight lowering,nateglinidetreatmentwasinferiortoagis. Conclusion Boththeeficacyandsafety,aswel astheprogressionofinsulinsecretionofnateglinidetreatmentwereconfirmedinthisstudy. Keywords Nateglinide;Diabetesmelitus,type2;Glycosylatedhemoglobin(HbA1c),, β ATP, Meta,, [1-2], [3-5],,, : ( ), : :, jiln@bjmu.edu.cn

2 914 χ2, (P>0.1, I 2 <50%), ; : PubMed EMBASE theco- (P<0.1,I 2 >50%), chranecontroled Trials Register ; : P, type2diabetes nateglinide ran- domizedcontroltrials(rct) Asian,628,108 [6-7] T2DM ; ;, 43 2 [6,8-14] 18;,8 [15-39] 12;HbA 1cFPG AGIs,25 [40-44],5,4, [45-48] SUs,, 21, 22 Cochrane HbA 1c Jadad,,HbA 1c BMI HbA 1c (WMD:-0.28%,95%CI:-0.41~ -0.14), HbA 1c FPG AGIs,HbA 1c (WMD:-0.27%, RevMan5.2 95%CI:-0.53~-0.02), SUs (WMD),,HbA 1c (OR) (1,1) Fig1 1 HbA1c WMDinchangesofHbA1cfornateglinidecomparedwithrepaglinide

3 915 1 Tab1 Comparisonsoftheeficacybetweennateglinideandotherantidiabeticagents ( ) No.ofstudies(No.ofparticipants) WMD 95%CI HbA1c(%) NateglinidevsPlacebo 2(44/46) * -0.41~-0.14 AGIsNateglinidevsAGIs 8(314/309) * -0.53~-0.02 NateglinidevsRepaglinide 24(1668/1668) ~0.33 Nateglinidevs Miliglinide 5(307/301) ~0.34 SUsNateglinidevsSUs 4(130/126) ~0.19 FPG(mmol/L) NateglinidevsPlacebo 2(44/46) ~0.01 AGIsNateglinidevsAGIs 6(255/250) ~0.28 NateglinidevsRepaglinide 25(1693/1695) 0.17 * 0.05~0.30 Nateglinidevs Miliglinide 5(307/301) ~0.08 SUsNateglinidevsSUs 4(130/126) ~0.65 Postprandialplasmaglucose(mmol/L) AGIsNateglinidevsAGIs 4(199/198) ~1.01 NateglinidevsRepaglinide 23(1197/1196) ~0.34 Nateglinidevs Miliglinide 5(307/301) ~0.72 SUsNateglinidevsSUs 4(130/126) ~0.33 FIns(IU/ml) NateglinidevsPlacebo 2(44/46) ~0.41 NateglinidevsRepaglinide 10(491/495) ~0.15 SUsNateglinidevsSUs 3(80/79) ~1.06 HOMA-IR NateglinidevsPlacebo 2(44/46) ~0.11 Weight(kg) AGIsNateglinidevsAGIs 4(224/219) 1.18 * 0.80~1.56 * Themeandiferenceissignificant FPG AGIs SUs (n=249)agis(n=244),fpg, (OR:1.54,,FPG 95%CI:0.32~7.37) (n=590), (WMD: (n=591), 0.17mmol/L,95%CI:0.05~0.30) (OR:0.53,95%CI:0.18~1.60) AGIs SUs, (1), (HOMA-IR), HbA 1c, SUs, T2DM,FIns,HOMA-IR, (1) ( ) AGIs,, AGIs, T2DM (WMD:1.18kg,95%CI:0.80~1.56),(1) SUs,,

4 916,HbA 1c, AGIs SUs ; -0.28% FPG, SUs AGIs, HbA 1c ;, [49], FIns AGIs,, HbA 1c AGIs,FPG HbA 1c,AGIs AGIs, 54%, [3], HbA 1c FPG, [5], Meta [4-5], HbA 1c, , FPG [3] HbA 1c FPG, 9:12.,, SUs, HbA 1c FPG,FIns, HbA 1c FPG,, [10],, HbA 1cFPG,,, HbA 1cFPG, 53: , [12],,, 9:9-11. [13], T2DM,HbA 1c, 10: AGIs,SUs ; FPG, logicapproachtoimproveglucosecontrol.currpharm Des, 2001,7: [1] Pratley RE,FoleyJE,DunningBE.Rapidactinginsulino- tropicagents:restorationofearlyinsulinsecretionasaphysio- [2] SalorantaC,HershonK,BalM,etal.Eficacyandsafetyof nateglinideintype2diabeticpatientswithmodestfastinghy- perglycemia.jclinendocrinolmetab,2002,87: ,,. 2 Meta.,2012,24: [4],,. 2.,2007,22: //. : : [6] KatoT,InoueT,NodeK.Postprandialendothelialdysfunc- tioninsubjectswithnew-onsettype2diabetes:anacarbose andnateglinidecomparativestudy.cardiovascdiabetol,2010, dergoodglycemiccontrol.arteriosclerthromb VascBiol, 2007,27: [8],,. 2.,2010,4: [9]. 2.,2010,12:33-35.,..,2009,48: [7] MitaT,WatadaH,ShimizuT,etal.NateglinideReducesCa- rotidintima-mediathickeningintype2diabeticpatientsun- [11] KurebayashiS,Watada H,TanakaY,etal.Eficacyand adverseefectsofnateglinideinearlytype2diabetescompari- sonwith Vogliboseinacross-overstudy.EndocrJ,2006,,. 2 β., 2011,,,. 2.,2011, [14], ,2009,20:56-57.

5 917 [15],,,..,2008,30: [16] LiC,XiaJ,ZhangG,etal.Nateglinideversusrepaglinide fortype2diabetes melitusinchina.acta Diabetol,2009, 46: [17] LiJ,Tian H,LiQ,etal.Improvementofinsulinsensitivity andbeta-celfunctionbynateglinideandrepaglinideintype2 diabeticpatients arandomizedcontroleddouble-blindand double-dummy multicentre clinical trial. Diabetes Obes Metab,2007,9: [18],,,. 2.,2005,21: :,2005, 36: [19],,,. [38],.2 2..,2007,23: ,2005,21: [20],,,. 2.,2004,9: [21],,,. mitiglinidecomparedwithnateglinideintype2diabetesmeli- 2. tuspatientsinchina.jintmedres,2009,37: ,2004,4: [41] LiL,Yang M,LiZ,etal.Eficacyandsafetyofmitiglinide [22],,. 2 versusnateglinideinnewlydiagnosepatientswithtype2dia-.,2005,25: betesmelitus:arandomizeddoubleblindtrial.diabetesobes [23],,,. 2 Metab,2012,14: β [42],. 2.,2005,21: [24],,. 2 β., 2005, 30: [25],,,. 2 [44],,,..,2007, 28: [26],,,. 2.,2005,3: [27],,,. 2 [47],,,. 2.,2006,16: ,2011,20: [28],,,. 2 [48],..,2004, 2.,2010, 8: [29],. 2. [49],,.,2007,14: [30]. 2.,2011,5: [31],,,..,2005,28: [32],. 2.,2005,26: [33],,,. 2.,2003,38: [34],,,. 442.,2005,34: [35],,,..,2006,15: [36],,,. I [37], ,2011,14: [39],,,..,2003,5: [40] GAO X;Mitiglinide Versus NateglinideComparisonStudy Group. Multicentre, double-blind, randomized study of.,2012,33: [43],,,. 2.,2009,30: ,2006,23: [45].,2005,26: [46],. 2.,2005,25: : ,2011,27:5a-1-3. ( : ) ( 本文编辑 : 王善思 )

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