Effects Of Sodium Glucose Cotransporter-2 Inhibitors On Body Weight And Blood Pressure In Patients Of Type 2 Diabetes

Aim:To assess the effects of SGLT-2 inhibitors on body weight,waist circumference and blood pressure in patients with T2DM.Methods:The PubMed,Cochrane Library,EMBASE,CBM,CNKI,VIP and WanFang databases was searched to identify randomized controlled trials of SGLT-2 inhibitors VS placebo in effects of SGLT-2 inhibitors on blood pressure and body weight.Retrieval time from database establishment to January 2018.According to the criteria of inclusion and exclusion,literature was screened.The quality was assessed according to the Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.The RevMan 5.3 software was used for Meta-analysis.The I~2 was used to test the heterogeneity and 0.05 was used as the test level.Results:A total of 45 RCTs involving 26581 patients with T2DM(17339 cases in SGLT-2 inhibitor group and 9242 cases in the control group).The published languages was English.Compared with the control,the SGLT-2 inhibitor showed a reduction of 1.36cm on waist circumference,95%CI(-1.62,-1.10).Body weight were significantly decreased in SGLT-2 inhibitors[total WMD=-1.83Kg,95%CI(-2.09,-1.56),P<0.01],the reduction of body weight was[WMD=-1.81Kg,95%CI(-1.98,-1.64),P<0.01];[WMD=-2.13 kg,95%CI(-3.79,-0.47),P<0.01];[WMD=-1.75Kg,95%CI(-2.05,-1.45),P<0.01]and[WMD=-1.57Kg,95%CI(-1.99,-1.15),P<0.01]respectively by dapagliflozin,canagliflozin,empagliflozin and ipraglifloizin.Weight loss was positively correlated with medication time and BMI.Compared with the control,SGLT-2 inhibitors was associated with more reducution on systolic blood pressure level[total WMD=-3.82mmHg,95%CI(-4.14,-3.49),P<0.01].Treatment with canagliflozin resulted in a superior reduction on systolic blood pressure level[WMD=-4.01mmHg,95%CI(-4.52,-3.49),P<0.01].The treatment effect of SGLT-2 inhibitors on diastolic blood pressure was[WMD=-1.66mmHg,95%CI(-1.87,-1.44),P<0.01]relative to control.Conclusion:SGLT-2 inhibitors can effectively reduce body weight,waist circumfer-ence and blood pressure in patients with T2DM.Weight loss was positively correlated with medication time and BMI.Treatment with canagliflozin maybe resulted in a superior reduction on body weight and systolic blood pressure.