Meta Analysis Of The Effect Of α-glucosidase Inhibitor On Cardiovascular Outcome In Patients With Impaired Glucose Tolerance

Objective:Meta analysis was used to evaluate the risk of cardiovascular events,cardiovascular death and all-cause death in patients with impaired glucose tolerance treated withα-glucosidase inhibitors.Methods:According to the predetermined retrieval method and retrieval strategy,the Chinese biomedical literature database,CNKI,Wanfang database and VIP database,and the English databases PubMed,EMBASE,webofscience and Cochrane library were searched to collect the published randomized controlled trials of AGIS in the treatment of IGT patients.Two researchers followed the established inclusion criteria and exclusion criteria At the same time,the quality of the included literature was evaluated.Finally,Revman 5.3 was used to meta analyze the data.Results:After screening,6 randomized controlled trials were included,a total of 9198 patients.Meta analysis results showed that:Compared with placebo or blank control subjects with impaired glucose tolerance,α-glucoside inhibitors were effective in reducing fasting blood glucose[MD=-0.16mmol/L,95%CI(-0.26,-0.06),P=0.001],2h postpranational blood glucose[MD=-1.01mmol/L,95%CI(-1.72,-0.29),I~2=98%,P=0.006],and glycated hemoglobin[MD=-0.22%,95%CI(-0.40,-0.04),P=0.02],Reduced risk of newly diagnosed diabetes[RR=0.82,95%CI(0.75,0.90),I~2=0%,P<0.0001];The incidence of gastroin-testinal adverse reactions such as abdominal distension and diarrhea withα-glucosidase inhibitors was high[RR=2.11,95%CI(1.36,3.28),I~2=70%,P<0.01];α-glucosidase inhibitor can reduce the serum triglyceride level[MD=-0.11mmol/L(-0.20,-0.02),P<0.05,I~2=0%],and significantly slow down the progress of carotid intima-media thickness[MD=-0.16,95%CI(-0.20,-0.12),I~2=0%,P<0.01].However,α-glucosidase inhibition did not reduce the risk of cardiovascular events[RR=0.76,95%CI(0.55,1.04),I~2=70%,P>0.05],cardiovascular death risk[RR=0.86,95%CI(0.70,1.07),I~2=0%,P>0.05]and all-cause death risk[RR=0.99,95%CI(0.83,1.17),I~2=27%,P>0.05].Conclusion:1.In patients with impaired glucose tolerance,α-glucosidase inhibitors can effectively reduce serum trigly-cerides and slow the progression of carotid intima-media thickness,but no significant cardiovascular benefit has been found.2.α-glucosidase inhibitors can regulate glucose metabo-lism and reduce the risk of diabetes;α-glucosidase inhibitors may indirectly reduce the risk of cardiovascular disease by preventing or delaying the onset of type 2 diabetes.