二甲双胍联合GLP-1受体激动剂对多囊卵巢综合征患者代谢特征影响的Meta分析

Abstract
Figure/Table
References (0)
Related Citation (15)

Download: PDF (1546 KB) HTML (1 KB)
Export: BibTeX | EndNote (RIS)

Abstract Objective: Meta-analysis was performed to assess the efficacy of metformin in combination with GLP-1 agonist on the Metabolic syndrome of women with polycystic ovary syndrome (PCOS). Methods: The randomized controlled trials (RCT) were retrieved from Pubmed, Cochrane library, EMbase, CNKI, WanFang and VIP database and references listed in all studies. RCTs meeting inclusive studies were included the data extracted, the quality was evaluated and cross-checked by two reviews independently according to Cochrane Handbook for Systematic Reviews of Interventions and then Meta-analysis was conducted using Stata 12.0 software. Results: A total of 4 studies were included, of which 61 were in test group (metformin combined with GLP-1 agonist) and 60 were in control group (GLP-1 agonist). The results of Meta-analysis showed that test group had a significant difference in waist circumference change compared with control group (SMD=0.39, 95%CI: 0.03-0.75, P=0.035), the rest in BMI (SMD=-0.13, 95%CI: -0.48-0.23, P=0.492), body mass (SMD=-0.19, 95%CI: -0.54-0.17, P=0.311), insulin resistance index (SMD=-0.68, 95%CI: -2.23-0.86, P=0.386), fasting insulin level (SMD=0.19, 95%CI: -0.28-0.66, P=0.426), sex hormone binding globulin (SMD=0.72, 95%CI: -0.55-2.00, P=0.266), serum total testosterone (SMD=-0.70, 95%CI: -1.98-0.57, P=0.279), there were no significant difference. Conclusion: Metformin combined with GLP-1 agonist is superior to GLP-1 agonist alone in improving the waist circumference of patients with PCOS. In contrast, metformin does not increase the therapeutic effect of GLP-1 agonists in BMI, body mass, insulin resistance index, fasting insulin level, sex hormone binding globulin, serum total testosterone.

Key words： GLP-1 agonists metformin polycystic ovary syndrome Meta-analysis

Received: 21 January 2019

	Service
	E-mail this article
	Add to my bookshelf
	Add to citation manager
	E-mail Alert
	RSS
	Articles by authors
	HU Pingping
	XU Leilai
	JIANG Xuelu.

URL:

https://xb.wmu.edu.cn/EN/ OR https://xb.wmu.edu.cn/EN/Y2019/V49/I6/447

[1] SIRMANS S M, PATE K A. Epidemiology, diagnosis, and management of polycystic ovary syndrome[J]. Clin Epidemiol, 2013, 6: 1-13.
[2] 黄晓燕, 吕红, 吴春香, 等. 多囊卵巢综合征患者的体质量指数和脂代谢水平对促性腺激素释放激素拮抗剂方案妊娠结局的影响[J]. 中华生殖与避孕杂志, 2018, 38(12): 969-975.
[3] 侯宇婕. 艾塞那肽联合二甲双胍在伴胰岛素抵抗的肥胖型PCOS患者中的临床疗效及安全性分析[J]. 川北医学院学报, 2018, 33(5): 731-733.
[4] NIAFAR M, NADER N D. Adiponectin as serum biomarker of insulin resistance in patients with polycystic ovarian syn-drome[J]. Gynecol Endocrinol, 2015, 31(6): 473-476.
[5] DIAMANTI-KANDARAKIS E, DUNAIF A. Insulin resistance and the polycystic ovary syndrome revisited: an update on mechanisms and implications[J]. Endocr Rev, 2012, 33(6): 981-1030.
[6] BILLA E, KAPOLLA N, NICOPOULOU S C, et al. Metformin administration was associated with a modification of LH, prolactin and insulin secretion dynamics in women with polycystic ovarian syndrome[J]. Gynecol Endocrinol, 2009, 25(7): 427-434.
[7] MIETLICKI-BAASE E G, ORTINSKI P I, REINER D J, et al. Glucagon-like peptide-1 receptor activation in the nucleus accumbens core suppresses feeding by increasing glutamatergic AMPA/kainate signaling[J]. J Neurosci, 2014, 34(20): 6985-6992.
[8] 曾利文, 张萍. 胰高血糖素样肽-1类似物对减重影响[J]. 中国实用内科杂志, 2017, 37(1): 17-20.
[9] 史薇, 朱鸿秋, 肖雪, 等. 达英-35联合中医治疗PCOS疗效的Meta分析[J]. 中国中医药现代远程教育, 2018, 16(21): 156-158.
[10] 马捷, 刘莹, 钟来平, 等. Jadad量表与Cochrane偏倚风险评估工具在随机对照试验质量评价中的应用与比较[J]. 中国口腔颌面外科杂志, 2012, 10(5): 417-422.
[11] ELKIND-HIRSCH K, MARRIONEAUX O, BHUSHAN M, et al. Comparison of single and combined treatment with exenatide and metformin on menstrual cyclicity in overweight women with polycystic ovary syndrome[J]. J Clin Endocrinol Metab, 2008, 93(7): 2670-2678.
[12] JENSTERLE M, GORICAR K, JANEZ A. Metformin as an initial adjunct to low-dose liraglutide enhances the weight-decreasing potential of liraglutide in obese polycystic ovary syndrome: Randomized control study[J]. Exp Ther Med, 2016, 11(4): 1194-1200.
[13] JENSTERLE SEVER M, KOCJAN T, PFEIFER M, et al. Short-term combined treatment with liraglutide and metformin leads to significant weight loss in obese women with polycystic ovary syndrome and previous poor response to metformin[J]. Eur J Endocrinol, 2014, 170(3): 451-459.
[14] JENSTERLE M, KRAVOS N A, GORIČAR K, et al. Short-term effectiveness of low dose liraglutide in combination with metformin versus high dose liraglutide alone in treatment of obese PCOS: randomized trial[J]. BMC Endocr Disord, 2017, 17(1): 5.
[15] 高芳, 杜海燕, 段彪, 等. 多囊卵巢综合征代谢异常的相关机制的论述[J]. 世界最新医学信息文摘, 2017, 17(95): 50-52, 55.
[16] ASTRUP A, ROSSNER S, VAN GAAL L, et al. Effects of liraglutide in the treatment of obesity: a randomised, double-blind, placebo-controlled study[J]. Lancet, 2009, 374(9701): 1606-1616.
[17] 张新霞, 童南伟. 胰高血糖素样肽-1受体激动剂在多囊卵巢综合征的临床应用[J]. 华西医学, 2018, 33(5): 611-615.
[18] 冯惠芳, 杜巧梅, 黄翠萍. 百令胶囊联合二甲双胍治疗对多囊卵巢综合征患者代谢指标及性激素的影响[J]. 新中医, 2018, 50(12): 137-139.
[19] MONAMI M, DICEMBRINI I, MARCHIONNI N, et al. Effects of glucagon-like peptide-1 receptor agonists on body weight: a Meta-analysis[J]. Exp Diabetes Res, 2012, 2012: 672658.
[20] VILSBOLL T, CHRISTENSEN M, JUNKER A E, et al. Effects of glucagon-like peptide-1 receptor agonists on weight loss: systematic review and Meta-analyses of randomised controlled trials[J]. BMJ, 2012, 344: d7771.
[21] NIAFAR M, POURAFKARI L, PORHOMAYON J, et al. A systematic review of GLP-1 agonists on the Metabolic syndrome in women with polycystic ovaries[J]. Arch Gynecol Obstet, 2016, 293(3): 509-515.