{"title":"伊米霉素在2型糖尿病患者血糖控制、β细胞功能和安全结局中的作用:一项综合荟萃分析","authors":"Palaniappan Vinayagam , Vengojayparassad Senathipathi , Vishnu Shivam , Nandhini Velraju","doi":"10.1016/j.deman.2023.100164","DOIUrl":null,"url":null,"abstract":"<div><h3>Purpose</h3><p>The aim of this meta-analysis is to evaluate the role of Imeglimin in glycemic control (HbA1c & FPG), Homeostatic Model Assessment of β-cell function, pro-insulin to c-peptide ratio and its safety outcomes in patients with type 2 diabetes mellitus.</p></div><div><h3>Methods</h3><p>A thorough literature search was performed on PubMed Central, PubMed, Cochrane, Wiley online library databases and efficacy outcomes such as changes in HbA1c, FPG, pro-insulin to c-peptide ratio and HOMA- β were summarized as standardized mean difference and safety outcomes were summarized as odds ratio. (PROSPERO registration no. CRD42023422787).</p></div><div><h3>Results</h3><p>Seven randomized controlled trials conducted on 1,454 patients with type 2 diabetes mellitus were included. Overall the random effects model meta-analysis of standardized mean difference demonstrated that Imeglimin was significantly associated with HbA1c reduction of -0.85% (95% CI -1.08 to -0.62, p<0.00001) with heterogeneity (i<sup>2</sup> = 70%, <em>p</em> = 0.002), fasting plasma glucose (FPG) reduction of -0.64 mmol/L (95% CI -0.81 to -0.47, <em>p</em><0.00001) with non-significant low heterogeneity (i<sup>2</sup> = 35%, <em>p</em> = 0.16) and significantly improved HOMA-β function by 0.46 (95% CI 0.25 to 0.67, <em>p</em><0.0001) compared to control groups with non-significant heterogeneity (i<sup>2</sup> = 4%, <em>p</em> = 0.31). Further, the overall analysis of gastrointestinal (GI) adverse events demonstrated that Imeglimin was significantly associated with GI events (OR, 1.83; 95% CI, 1.19 to 2.82; <em>p</em> = 0.006) with no heterogeneity (i<sup>2</sup> = 0%, <em>p</em> = 0.80).</p></div><div><h3>Conclusion</h3><p>Our results demonstrated that Imeglimin is significantly associated with the glycemic control (reduction of HbA1c by -0.85% & FPG by -0.64 mmol/L), improved beta cell function (HOMA-β by 0.46) and associated with GI adverse events by 1.83 fold increased odds as compared to controls.</p></div>","PeriodicalId":1,"journal":{"name":"Accounts of Chemical Research","volume":null,"pages":null},"PeriodicalIF":16.4000,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"The role of Imeglimin in glycemic control, beta cell function and safety outcomes in patients with type 2 diabetes mellitus: A comprehensive meta-analysis\",\"authors\":\"Palaniappan Vinayagam , Vengojayparassad Senathipathi , Vishnu Shivam , Nandhini Velraju\",\"doi\":\"10.1016/j.deman.2023.100164\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Purpose</h3><p>The aim of this meta-analysis is to evaluate the role of Imeglimin in glycemic control (HbA1c & FPG), Homeostatic Model Assessment of β-cell function, pro-insulin to c-peptide ratio and its safety outcomes in patients with type 2 diabetes mellitus.</p></div><div><h3>Methods</h3><p>A thorough literature search was performed on PubMed Central, PubMed, Cochrane, Wiley online library databases and efficacy outcomes such as changes in HbA1c, FPG, pro-insulin to c-peptide ratio and HOMA- β were summarized as standardized mean difference and safety outcomes were summarized as odds ratio. (PROSPERO registration no. CRD42023422787).</p></div><div><h3>Results</h3><p>Seven randomized controlled trials conducted on 1,454 patients with type 2 diabetes mellitus were included. Overall the random effects model meta-analysis of standardized mean difference demonstrated that Imeglimin was significantly associated with HbA1c reduction of -0.85% (95% CI -1.08 to -0.62, p<0.00001) with heterogeneity (i<sup>2</sup> = 70%, <em>p</em> = 0.002), fasting plasma glucose (FPG) reduction of -0.64 mmol/L (95% CI -0.81 to -0.47, <em>p</em><0.00001) with non-significant low heterogeneity (i<sup>2</sup> = 35%, <em>p</em> = 0.16) and significantly improved HOMA-β function by 0.46 (95% CI 0.25 to 0.67, <em>p</em><0.0001) compared to control groups with non-significant heterogeneity (i<sup>2</sup> = 4%, <em>p</em> = 0.31). Further, the overall analysis of gastrointestinal (GI) adverse events demonstrated that Imeglimin was significantly associated with GI events (OR, 1.83; 95% CI, 1.19 to 2.82; <em>p</em> = 0.006) with no heterogeneity (i<sup>2</sup> = 0%, <em>p</em> = 0.80).</p></div><div><h3>Conclusion</h3><p>Our results demonstrated that Imeglimin is significantly associated with the glycemic control (reduction of HbA1c by -0.85% & FPG by -0.64 mmol/L), improved beta cell function (HOMA-β by 0.46) and associated with GI adverse events by 1.83 fold increased odds as compared to controls.</p></div>\",\"PeriodicalId\":1,\"journal\":{\"name\":\"Accounts of Chemical Research\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":16.4000,\"publicationDate\":\"2023-10-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Accounts of Chemical Research\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S2666970623000367\",\"RegionNum\":1,\"RegionCategory\":\"化学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"CHEMISTRY, MULTIDISCIPLINARY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Accounts of Chemical Research","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2666970623000367","RegionNum":1,"RegionCategory":"化学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"CHEMISTRY, MULTIDISCIPLINARY","Score":null,"Total":0}
引用次数: 0
摘要
目的:本荟萃分析的目的是评估依米明在血糖控制(HbA1c &2型糖尿病患者β细胞功能、前胰岛素与c肽比值及其安全性结局的评估。方法在PubMed Central、PubMed、Cochrane、Wiley在线图书馆数据库中进行全面的文献检索，将HbA1c、FPG、前胰岛素与c肽比值、HOMA- β等疗效指标的变化汇总为标准化平均差，将安全性指标汇总为优势比。普洛斯彼罗登记号码:CRD42023422787)。结果纳入7项随机对照试验，共纳入1454例2型糖尿病患者。总体而言，标准化平均差异的随机效应模型荟萃分析显示，依美美明与HbA1c降低-0.85% (95% CI -1.08至-0.62,p = 0.00001)具有异质性(i2 = 70%， p = 0.002)，空腹血糖(FPG)降低-0.64 mmol/L (95% CI -0.81至-0.47,p = 0.00001)具有非显著的低异质性(i2 = 35%， p = 0.16)，显著改善HOMA-β功能0.46 (95% CI 0.25至0.67,p = 0.00001)相关。P<0.0001)，而非显著异质性的对照组(i2 = 4%， p = 0.31)。此外，胃肠道(GI)不良事件的总体分析表明，依米明与GI事件显著相关(OR, 1.83;95% CI, 1.19 ~ 2.82;p = 0.006),没有异质性(i2 = 0%, p = 0.80)。结论:我们的研究结果表明，依米明与血糖控制(HbA1c降低-0.85%)显著相关;FPG降低-0.64 mmol/L)，改善了β细胞功能(HOMA-β降低0.46)，与对照组相比，与胃肠道不良事件相关的几率增加了1.83倍。
The role of Imeglimin in glycemic control, beta cell function and safety outcomes in patients with type 2 diabetes mellitus: A comprehensive meta-analysis
Purpose
The aim of this meta-analysis is to evaluate the role of Imeglimin in glycemic control (HbA1c & FPG), Homeostatic Model Assessment of β-cell function, pro-insulin to c-peptide ratio and its safety outcomes in patients with type 2 diabetes mellitus.
Methods
A thorough literature search was performed on PubMed Central, PubMed, Cochrane, Wiley online library databases and efficacy outcomes such as changes in HbA1c, FPG, pro-insulin to c-peptide ratio and HOMA- β were summarized as standardized mean difference and safety outcomes were summarized as odds ratio. (PROSPERO registration no. CRD42023422787).
Results
Seven randomized controlled trials conducted on 1,454 patients with type 2 diabetes mellitus were included. Overall the random effects model meta-analysis of standardized mean difference demonstrated that Imeglimin was significantly associated with HbA1c reduction of -0.85% (95% CI -1.08 to -0.62, p<0.00001) with heterogeneity (i2 = 70%, p = 0.002), fasting plasma glucose (FPG) reduction of -0.64 mmol/L (95% CI -0.81 to -0.47, p<0.00001) with non-significant low heterogeneity (i2 = 35%, p = 0.16) and significantly improved HOMA-β function by 0.46 (95% CI 0.25 to 0.67, p<0.0001) compared to control groups with non-significant heterogeneity (i2 = 4%, p = 0.31). Further, the overall analysis of gastrointestinal (GI) adverse events demonstrated that Imeglimin was significantly associated with GI events (OR, 1.83; 95% CI, 1.19 to 2.82; p = 0.006) with no heterogeneity (i2 = 0%, p = 0.80).
Conclusion
Our results demonstrated that Imeglimin is significantly associated with the glycemic control (reduction of HbA1c by -0.85% & FPG by -0.64 mmol/L), improved beta cell function (HOMA-β by 0.46) and associated with GI adverse events by 1.83 fold increased odds as compared to controls.
期刊介绍：
Accounts of Chemical Research presents short, concise and critical articles offering easy-to-read overviews of basic research and applications in all areas of chemistry and biochemistry. These short reviews focus on research from the author’s own laboratory and are designed to teach the reader about a research project. In addition, Accounts of Chemical Research publishes commentaries that give an informed opinion on a current research problem. Special Issues online are devoted to a single topic of unusual activity and significance.
Accounts of Chemical Research replaces the traditional article abstract with an article "Conspectus." These entries synopsize the research affording the reader a closer look at the content and significance of an article. Through this provision of a more detailed description of the article contents, the Conspectus enhances the article's discoverability by search engines and the exposure for the research.
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