| Background:With the rapid development of economy,the change of life style and the increase of population aging,the prevalence of obesity and type 2 diabetes has increased,and type 2 diabetes has become a global public health problem.Metformin and acarbose are commonly used hypoglycemic drugs for the control of blood glucose in type 2diabetes patients.Several studies have shown that both metformin and acarbose have a role in reducing body weight in the treatment of type 2 diabetes,but the effects of both on body weight loss have not yet been finalized.For this purpose,this article will search related literature for meta-analysis to compare the effect of acarbose and metformin on weight loss in the treatment of type 2 diabetes.As the common side effects of the two drugs are gastrointestinal adverse reactions,the incidence of gastrointestinal adverse reactions was analyzed.Methods:Computer search PubMed,Embase,Cochrane Library,Chinese Biomedical Literature Database,China Knowledge Network,and Wanfang Database.A literature comparing the effects of acarbose and metformin on weight loss in patients with type2 diabetes.In February 2018,the library was not limited in language,but was screened according to the standards of the included literature and exclusion criteria,and reference was made to the relevant references for supplementation.Statistical analysis was performed using STATA 14 software to calculate the weighted mean difference in body weight between the acarbose group and metformin group,the hazard ratio at the 95%confidence interval and the gastrointestinal adverse reaction,95%confidence interval;according to the study population and metformin Different doses were used for subgroup analysis.The metanif command was used for sensitivity analysis to assess the stability of the results.Funnel diagram method,Egger linear regression method,and clipping complement method were used to evaluate publication bias.Result:A total of 526 preliminary search documents were found.After screening,six articles were eventually included in the study.There were 1,022 type 2 diabetic patients,of whom 517 were in the acarbose group and 505 were in the metformin group.Statistical analysis:The acarbose had better weight loss than the metformin in the treatment of type 2 diabetes,and the difference was statistically significant(WMD=-0.55,95%CI[-1.01,-0.09],P=0.019).According to the subgroup analysis of racial and metformin doses,the statistical heterogeneity of the Caucasian group(P=0.275,I~2=22.5%),the statistical heterogeneity of the Asian group(P=0.570,I~2=0%).The statistical heterogeneity of metformin 1700mg/d group(P=0.346,I2=7.5%),and the statistical heterogeneity of metformin 1500mg/d group(P=0.967,I2=0%).The meta-analysis shows that the heterogeneity of the two subgroups is not large.Publication bias analysis shows that the funnel diagram analysis of the included literature is not intuitively symmetric,which indicates that there is a possibility of publication bias in the included literature;Egger linear regression analysis and row shear compensation analysis showed that the publication bias was less likely;Sensitivity analysis showed that the results of this study have certain reliability and stability.The difference of the incidence of gastrointestinal adverse reactions between acarbose and metformin in the treatment of type 2 diabetes was not statistically significant(RR=1.411,95%CI[0.622,3.203],P=0.41).Conclusions:This meta-analysis study shows that in Asian population,acarbose may be more effective than metformin in the weight reduction of type 2 diabetic patients,especially in newly diagnosed patients,but there is no statistical difference in the incidence of gastrointestinal adverse reactions.As the design schemes in these studies are different and the total sample size in this meta-analysis study is insufficient,more large-scale multi-center clinical trials are needed. |
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