囊性纤维化跨膜传导调节治疗对囊性纤维化患者血糖控制的影响：一项荟萃分析

IF 5.4 2区医学 Q1 RESPIRATORY SYSTEM

Journal of Cystic Fibrosis Pub Date : 2025-06-01 DOI:10.1016/j.jcf.2025.03.585

S. Kiss , M.F. Juhász , T. Kói , K. Ocskay , A. Párniczky

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引用次数: 0

摘要

囊性纤维化相关性糖尿病（CFRD）显著影响囊性纤维化（pwCF）患者的健康结局。了解囊性纤维化跨膜传导调节剂（CFTRm）治疗对血糖控制的影响对改善整体健康至关重要。目的评价CFTRm治疗对pwCF患者血糖控制的影响。方法从2011年1月1日至2024年9月19日，在PubMed、Embase、Cochrane Central Register of Controlled Trials中进行综合文献检索。符合条件的研究包括比较CFTRm治疗与不治疗或安慰剂的介入性试验。观察性研究报告了pwCF治疗前和治疗中血糖结局的数据，以及pwCF治疗中与对照组相比的数据。主要结果包括口服葡萄糖耐量试验（OGTT）结果、国际公认的连续血糖监测（CGM）措施和血红蛋白A1c （HbA1c）水平。两位作者完全遵循PRISMA指南独立提取数据。通过计算95%置信区间（CI）的均值差（MD）进行数据合成；数据采用随机效应模型汇总。采用回归分析来评估CFTR调节剂治疗效果与患者年龄和治疗时间之间的关系。在77项研究中，CFTRm治疗显著改善了120分钟血糖水平(MD, -0.74 mmol/L；95% CI, -1.42至-0.07)，降低HbA1c水平(MD, -0.31%；95% CI, -0.55至-0.07)，并减少了高血糖（>10 mmol/L）的时间(MD, -0.92%；95% CI, -1.75 ~ -0.09)。回归分析显示，更早开始治疗与更稳定的血糖水平（p=0.0471）和更好的HbA1c值（p=0.0001）相关。结论scftrm治疗可显著改善pwCF患者的血糖控制。较早开始治疗与较好的结果相关。资助：国家研究、发展和创新基金（NRDI基金）FK 138929；CF信托战略研究联盟基金NU-000600

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WS16.04The effects of cystic fibrosis transmembrane conductance regulator modulator therapy on glycaemic control in patients with cystic fibrosis: a meta-analysis

Introduction

Cystic fibrosis-related diabetes (CFRD) significantly impacts health outcomes of people with cystic fibrosis (pwCF). Understanding the effects of cystic fibrosis transmembrane conductance regulator modulator (CFTRm) therapy on glycaemic control is crucial for improving overall health.

Objective

To evaluate the impact of CFTRm therapy on glycaemic control in pwCF.

Methods

A comprehensive literature search was conducted from January 1, 2011 to September 19, 2024, in PubMed, Embase, and Cochrane Central Register of Controlled Trials. Eligible studies included interventional trials comparing CFTRm therapy with either no treatment or placebo. Observational studies reporting data on glycemic outcomes in pwCF pre-therapy and on-therapy, as well as pwCF on-therapy compared to controls were eligible. Primary outcomes included oral glucose tolerance test (OGTT) results, internationally accepted continuous glucose monitoring (CGM) measures and haemoglobin A1c (HbA1c) levels. Two authors independently extracted data with full adherence to PRISMA guidelines. Data synthesis was performed by calculating mean differences (MD) with 95% confidence intervals (CI); data were pooled using a random-effects model. Regression analyses were performed to evaluate the relationship between the effects of CFTR modulator therapy and both patient age and length of therapy.

Results

Across 77 studies, CFTRm therapy significantly improved 120-minute glucose levels (MD, -0.74 mmol/L; 95% CI, -1.42 to -0.07), lowered HbA1c levels (MD, -0.31%; 95% CI, -0.55 to -0.07), and reduced time spent in hyperglycaemia (>10 mmol/L) as measured by CGM (MD, -0.92%; 95% CI, -1.75 to -0.09). Regression analyses showed that earlier therapy initiation was associated with more stable glucose levels (p=0.0471) and better HbA1c values (p=0.0001).

Conclusions

CFTRm therapy significantly improved glycaemic control in pwCF. Earlier treatment initiation was associated with better outcomes.

Funding: National Research, Development and Innovation Fund (NRDI Fund) FK 138929; CF Trust Strategic Research Consortium Grant NU-000600

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来源期刊

Journal of Cystic Fibrosis 医学-呼吸系统

CiteScore

10.10

自引率

13.50%

发文量

1361

审稿时长

50 days

期刊介绍： The Journal of Cystic Fibrosis is the official journal of the European Cystic Fibrosis Society. The journal is devoted to promoting the research and treatment of cystic fibrosis. To this end the journal publishes original scientific articles, editorials, case reports, short communications and other information relevant to cystic fibrosis. The journal also publishes news and articles concerning the activities and policies of the ECFS as well as those of other societies related the ECFS.