胰高血糖素样肽-1受体激动剂治疗多囊卵巢综合征患者有效性与安全性的Meta分析

目的 评价胰高血糖素样肽-1(glucagon like peptide-1, GLP-1)受体激动剂与二甲双胍治疗多囊卵巢综合征(polycystic ovarian syndrome, PCOS)的有效性与安全性。方法 计算机检索英文数据库PubMed、CENTRAL(2020年第3期)、EMbase;中文数据库Wanfang Data、CNKI、CBM。检索时限定义为建库至2020年4月。查找有关GLP-1受体激动剂与二甲双胍治疗PCOS患者有效性与安全性的随机对照试验(RCT)。由两名参与者进行文献筛查、资料提取并评价所纳入研究偏倚风险后,采用RevMan 5.3软件进行Meta分析。结果 最终纳入10项RCT,共计654例患者。在有效性方面, GLP-1组体重指数(BMI)、腹围明显低于二甲双胍组。GLP-1组HOMA-IR明显低于二甲双胍组。在安全性方面,GLP-1组恶心、头痛发生率明显高于二甲双胍组。GLP-1组腹泻发生率明显低于二甲双胍组。结论 GLP-1受体激动剂在降低PCOS患者BMI、腹围以及对抗胰岛素抵抗方面明显优于二甲双胍,但更易导致患者恶心、头痛等不良反应。

Meta-analysis on efficacy and safety of glucagon like peptide-1 receptor agonist on patients with polycystic ovary syndrome

Objective To evaluate the efficacy and safety of glucagon like peptide-1(GLP-1) receptor agonist and metformin for the treatment of polycystic ovary syndrome (PCOS). Methods Two researchers searched the databases including PubMed, CENTRAL (Issue 3, 2020), EMbase, Wanfang Data, CBM, CNKI to collect the randomized controlled trails (RCTs) about GLP-1 receptor agonist for polycystic ovary syndrome, the retrieval time limit was defined as from the establishment of the database until April 2020. The two researchers screened the literature, extracted data, and evaluated the risk of bias in the included research data, and used RevMan 5.3 software to conduct a meta-analysis. Results A total of 10 RCTs (5 RCTs with exenatide and 5 RCTs with liraglutide) involving 654 patients were included. In terms of efficacy, body mass index (BMI), abdominal circumference, homeostasis model assessment of insulin resistance (HOMA-IR) in GLP-1 group were significantly lower than those in metformin group. In safety, the incidence of nausea and headache in GLP-1 group was significantly higher than those in metformin group. The incidence of diarrhea in GLP-1 group was significantly lower than that in metformin group. Conclusion GLP-1 receptor agonists were significantly better than metformin in reducing BMI, abdominal circumference, HOMA-IR in PCOS patients. However, the medicines are more likely to cause adverse reactions such as nausea and headache.