胰高血糖素样肽1受体激动剂对亚洲人群与白人人群心血管结局的比较疗效：有或无2型糖尿病和/或超重或肥胖人群随机试验的系统评价和荟萃分析

IF 16.6 1区医学 Q1 ENDOCRINOLOGY & METABOLISM

Diabetes Care Pub Date : 2025-02-20 DOI:10.2337/dc24-1533

Matthew M.Y. Lee, Nazim Ghouri, Anoop Misra, Yu Mi Kang, Martin K. Rutter, Hertzel C. Gerstein, Darren K. McGuire, Naveed Sattar

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引用次数: 0

摘要

心血管结局试验（CVOTs）表明，与白人相比，胰高血糖素样肽1受体激动剂（GLP-1RAs）在亚洲人中提供了更大的心血管（CV）益处。目的比较GLP-1RAs在亚裔和白人人群中的CV疗效。数据来源PubMed和ClinicalTrials.gov的系统综述（2015年1月1日至2024年11月1日）。研究选择随机安慰剂对照GLP-1RAs CVOTs。评估偏倚风险（RoB 2）。主要不良心血管事件（MACE）的种族特异性风险比（hr）。根据系统评价和荟萃分析（PRISMA）指南的首选报告项目进行随机效应荟萃分析，包括8项试验（5909名亚洲人，55855名白人）。glp - 1ra相关的MACE HR在亚洲人群中为0.69 (95% CI 0.58, 0.83)，在白人中为0.85 (95% CI 0.79, 0.91) （p - interaction = 0.045）。亚洲人的绝对MACE风险降低2.9% (95% CI 1.5, 4.2)，而白人的MACE风险降低1.4% （95% CI 0.9, 1.9）。由于缺乏个体患者水平的数据，无法对亚洲组进行详细的亚分类。结论：与白人相比，GLP-1RAs可能使亚洲人的MACE降低更大。

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Comparative Efficacy of Glucagon-Like Peptide 1 Receptor Agonists for Cardiovascular Outcomes in Asian Versus White Populations: Systematic Review and Meta-analysis of Randomized Trials of Populations With or Without Type 2 Diabetes and/or Overweight or Obesity

BACKGROUND Cardiovascular outcome trials (CVOTs) suggest glucagon-like peptide 1 receptor agonists (GLP-1RAs) provide greater cardiovascular (CV) benefits in Asian compared with White individuals. PURPOSE Compare CV efficacy of GLP-1RAs between Asian and White individuals. DATA SOURCES Systematic review of PubMed and ClinicalTrials.gov (1 January 2015 to 1 November 2024). STUDY SELECTION Randomized placebo-controlled CVOTs of GLP-1RAs. Risk of bias was assessed (RoB 2). DATA EXTRACTION Ethnicity-specific hazard ratios (HRs) for major adverse cardiovascular events (MACE). DATA SYNTHESIS Random-effects meta-analyses per Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines included eight trials (5,909 Asian individuals, 55,855 White individuals). GLP-1RA–associated MACE HR was 0.69 (95% CI 0.58, 0.83) in Asian people and 0.85 (95% CI 0.79, 0.91) in White people (Pinteraction = 0.045). Absolute MACE risk reduction was 2.9% (95% CI 1.5, 4.2) in Asian people versus 1.4% (0.9, 1.9) in White people. LIMITATIONS Lack of individual patient-level data precluded detailed subclassification of the Asian group. CONCLUSIONS GLP-1RAs may offer greater MACE reductions in Asian compared with White individuals.

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来源期刊

Diabetes Care 医学-内分泌学与代谢

CiteScore

27.80

自引率

4.90%

发文量

449

审稿时长

1 months

期刊介绍： The journal's overarching mission can be captured by the simple word "Care," reflecting its commitment to enhancing patient well-being. Diabetes Care aims to support better patient care by addressing the comprehensive needs of healthcare professionals dedicated to managing diabetes. Diabetes Care serves as a valuable resource for healthcare practitioners, aiming to advance knowledge, foster research, and improve diabetes management. The journal publishes original research across various categories, including Clinical Care, Education, Nutrition, Psychosocial Research, Epidemiology, Health Services Research, Emerging Treatments and Technologies, Pathophysiology, Complications, and Cardiovascular and Metabolic Risk. Additionally, Diabetes Care features ADA statements, consensus reports, review articles, letters to the editor, and health/medical news, appealing to a diverse audience of physicians, researchers, psychologists, educators, and other healthcare professionals.