| Background and objective:With the improved quality of life,the morbidity of the diabetes mellitus was increased annually.Primary prevention and early intervention were of paramount importance to prevent the development of diabetes mellitus.Patients with early diabetes mellitus had a risk of developing type 2 diabetes mellitus.Besides,the incidence of cardiovascular and cerebrovascular diseases was increasing in this period.Due to the reversibility of the disorder of glucose and lipid metabolism,active intervention was performed significantly.In addition to dietary treatment and increased exercise appropriately,early pharmacological intervention,such as metformin and acarbose,was also performed essentially.However,glucose metabolism and lipid metabolism was interacted on each other,whether lipid-lowering agents can reduce the level of blood glucose was still unknown.With an attempt to counseling relevant literature,we found fibrates had a role in individuals with diabetic patients combined hypertriglyceridemia and the mechanism was also complex.But there was continued debate regarding whether fibrates can reduce the level of blood glucose and improve the index for insulin resistance.The aim of this study was to collect the data about randomized controlled trials on patients underwent early diabetes mellitus combined hypertriglyceridemia,which were intervened by fenofibrate,then combined the data and evaluated objectively the effects of fenofibrate on glucose metabolism,insulin sensitivity and lipid metabolism.An attempt should be made to identify the sources of heterogeneity to provide feasible basis and design ideas for more clinical research and several evidences for clinical treatment.Methods:We conducted the search systemically and thoroughly in relevant databases at home and abroad,such as Pubmed and EMbase databases,the retrieval type were made from“(fibrates OR fenofibrate)AND(glucose)”.Using the MESH heading search strategy of the terms “glucose metabolism”,“early stage of diabetes mellitus”,“impaired fasting glucose”,“impaired glucose tolerance”,“fenofibrate” through CNKI,wanfang and VIP.The literatures was screened independently by two authors.Screening and enrolling patients with early stage of diabetes mellitus treated with fenofibrate to randomized controlled trials(RCTs),patients treated with fenofibrate were assigned to the test group and control group was only dietary management.Data extraction and evaluation of trials were performed after screening and enrolling.Review Manager 5.3 were used for sensitivity analysis and assessment for bias.Results:After screening,7 RCTs were included in the final study,and a total of 374 subjects were enrolled.The data were analyzed by meta and given the result as follows: Compared with the control group,the treatment group of FPG are decreased 1.56(95%CI=-2.46~-0.66,P<0.01),2hPG decreased 1.70(95%CI=-2.48~-0.92,P<0.0001),FINS decreased 1.71(95%CI=-2.56~-0.86,P<0.0001),HOMA-IR decree sed 3.45(95%CI=-5.55~-1.35,P=0.0001<0.01),TG decreased 3.41(95%CI=-4.44~-2.38,P<0.01)and HDL increased 1.84(95%CI=0.74~2.95,P<0.01).All the results were statistically significant.Conclusion:In the pre-diabetic patients combined hypertriglyceridemia,compared with the control group,the level of FPG?2hPG in the treatment group,which were treated with fenofibrate,were significantly reduced and FINS?HOMA-IR were significantly improved,and Fenofibrate significantly decreased the level of TG,increased levels of HDL. |
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