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:10.3969/j.issn.1006-6187.2013.10.014 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,E-mail: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],,, : (81000334), :100044 :,E-mail:jiln@bjmu.edu.cn
914 χ2, (P>0.1, I 2 <50%), ; : PubMed EMBASE theco- (P<0.1,I 2 >50%), chranecontroled Trials Register ; : P, 19901 20136 2 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
915 1 Tab1 Comparisonsoftheeficacybetweennateglinideandotherantidiabeticagents ( ) No.ofstudies(No.ofparticipants) WMD 95%CI HbA1c(%) NateglinidevsPlacebo 2(44/46) -0.28 * -0.41~-0.14 AGIsNateglinidevsAGIs 8(314/309) -0.27 * -0.53~-0.02 NateglinidevsRepaglinide 24(1668/1668) 0.10-0.13~0.33 Nateglinidevs Miliglinide 5(307/301) 0.16-0.01~0.34 SUsNateglinidevsSUs 4(130/126) -0.30-0.79~0.19 FPG(mmol/L) NateglinidevsPlacebo 2(44/46) -0.36-0.73~0.01 AGIsNateglinidevsAGIs 6(255/250) 0.07-0.14~0.28 NateglinidevsRepaglinide 25(1693/1695) 0.17 * 0.05~0.30 Nateglinidevs Miliglinide 5(307/301) -0.13-0.33~0.08 SUsNateglinidevsSUs 4(130/126) 0.24-0.17~0.65 Postprandialplasmaglucose(mmol/L) AGIsNateglinidevsAGIs 4(199/198) -0.03-1.06~1.01 NateglinidevsRepaglinide 23(1197/1196) 0.11-0.13~0.34 Nateglinidevs Miliglinide 5(307/301) 0.17-0.37~0.72 SUsNateglinidevsSUs 4(130/126) -0.86-2.05~0.33 FIns(IU/ml) NateglinidevsPlacebo 2(44/46) -0.82-2.05~0.41 NateglinidevsRepaglinide 10(491/495) 0.03-0.09~0.15 SUsNateglinidevsSUs 3(80/79) -0.65-2.36~1.06 HOMA-IR NateglinidevsPlacebo 2(44/46) -0.36-0.82~0.11 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,,
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