利拉鲁肽治疗多囊卵巢综合征的系统评价和meta分析

Efficacy of Liraglutide in Treating Polycystic Ovary Syndrome: A Systematic Review and Meta-analysis

关键词:  利拉鲁肽  多囊卵巢综合征  疗效  安全性  系统评价  meta分析

Key words:  liraglutide  polycystic ovary syndrome  efficacy  safety  systematic review  meta-analysis

摘要:

目的 系统评价利拉鲁肽治疗多囊卵巢综合征（polycystic ovary syndrome，PCOS）的疗效和安全性。方法 计算机检索Cochrane Library、PubMed、Embase、Web of Science、中国知网、中国生物医学文献数据库、维普数据库、万方数据库中已发表的相关文献，纳入利拉鲁肽治疗PCOS的临床随机对照试验（randomized controlled trials，RCTs），检索时间均从建库至2019年6月。利用RevMan 5.3软件进行统计分析。结果 共纳入7篇RCTs，共450例患者，meta分析结果显示：利拉鲁肽治疗PCOS与对照组相比，体质量（SMD=-0.53，95%CI=-0.78~-0.28，P<0.000 1，I²=48%）、腰围（SMD=-0.53，95%CI=-0.96~-0.09，P=0.02，I²=71%）、体质量指数（body mass index，BMI）（MD=-1.88，95%CI=-2.50~-1.27，P<0.000 01，I²=84%）、2 h餐后血糖（postprandial blood glucose，PBG）（SMD=-0.64，95%CI=-0.88~-0.40，P<0.000 01，I²=0%）有明显改善；睾酮（SMD=0.08，95%CI=-0.27~0.43，P=0.66，I²=57%）、促黄体素（luteinizing hormone，LH）（SMD=-0.45，95%CI=-1.03~0.12，P=0.12，I²=81%）、胰岛素抵抗指数（homeostasis model assessment-insulin resistance，HOMA-IR）（SMD=-0.04，95%CI=-0.59~0.51，P=0.89，I²=78%）的改善与对照组无明显差异；试验组不良反应发生率明显高于对照组（RR=2.06，95%CI=1.09~3.90，P=0.03，I²=62%）。结论 利拉鲁肽治疗PCOS在控制体质量和降低餐后血糖方面疗效显著，但在改善性激素水平和控制胰岛素抵抗方面与对照组无明显差异，同时利拉鲁肽组患者不良反应发生率明显高于对照组。

Abstract:

OBJECTIVE To systematically evaluate the efficacy of liraglutide in treatment of polycystic ovary syndrome (PCOS). METHODS Cochrane Library, PubMed, Embase, Web of Science, CNKI, CBM, VIP databases, Wanfang databases were searched by computer to collect the literatures on clinical randomized controlled trials(RCTs) of liraglutide in the treatment of PCOS from inception to June 2019. Meta-analysis was performed by RevMan 5.3 software. RESULTS A total of 7 RCTs involving 450 patients were included. The results of the meta-analysis showed that, compared with the control group, there were obvious improvement in the values of body weight(SMD=-0.53, 95%CI=-0.78--0.28, P<0.000 1, I²=48%), waist circumference(SMD=-0.53, 95%CI=-0.96--0.09, P=0.02, I²=71%), body mass index(BMI)(MD=-1.88, 95%CI=-2.50--1.27, P<0.000 01, I²=84%), 2 h postprandial blood glucose(PBG)(SMD=-0.64, 95%CI=-0.88--0.40, P<0.000 01, I²=0%). However, there were no obvious differences between two groups in testosterone(SMD=0.08, 95%CI=-0.27-0.43, P=0.66, I²=57%), luteinizing hormone(LH)(SMD=-0.45, 95%CI=-1.03-0.12, P=0.12, I²=81%), homeostasis model assessment-insulin resistance (HOMA-IR)(SMD=-0.04, 95%CI=-0.59-0.51, P=0.89, I²=78%). The incidence of adverse reactions in the test group was higher than that in the control group, and the difference was statistically significant(RR=2.06, 95%CI=1.09-3.90, P=0.03, I²=62%). CONCLUSION Liraglutide in treatment of PCOS is effective in controlling body weight and reducing PBG, but there is no significant difference campared with the control group in improving sex hormone levels and controlling insulin resistance. Meanwhile, the incidence of adverse reactions in the liraglutide group is significantly higher than in the control group.