Effects Of Sodium Glucose Cotransporter-2 Inhibitors On Lipids In Patients With Type 2 Diabetes:a Systematic Review

Objections:To systematically evaluate the effect of sodium-glucose co-transporter-2 inhibitor(SGLT-2i)on lipids in patients with type 2 diabetes mellitus(T2DM).Methods:We searched multiple database including PubMed,EBSCO,Cochrane Library,Wanfang,CNKI,VIP database,and clinicaltrials.gov from January 2008 to June 2018 to collect the effects of SGLT-2i on T2DM lipids in randomized controlled trials(RCT).Screening studies according to the inclusion and exclusion criteria of the study,and finished the data extraction and quality assessment.Use RevMan 5.3 software into the research for statistical analysis,MD was selected as the effect quantity,choose fixed effect model or random effects model according to the degree of heterogeneity for Meta analysis,using the sensitivity analysis to evaluate the stability of outcomes,the Funnel plot used to evaluate publication bias.Results:24 studies involving,9,750 subjects were eventually included.Meta analysis results:When the treatment cycle?28W,compared with the control group,SGLT2i group could significantly reduce TG[MD=-0.13,95%CI(-0.18,-0.09),P<0.00001,I~2=13%],significantly increase TC[MD=0.09,95%CI(0.05,0.13),P<0.00001,I~2=0%],HDL-C[MD=0.07,95%CI(0.06,0.08),P<0.00001,I~2=0%],LDL-C[MD=0.10,95%CI(0.08,0.13),P<0.00001,I~2=9%]level.When?52W,there was no statistical difference in the effect of SGLT-2i group on TG level compared with the control group[MD=-0.01,95%CI(-0.08,0.06),P=0.79,I~2=0%],but it could significantly increase TC[MD=0.14,95%CI(0.08,0.20),P<0.00001,I~2=0%],HDL-C[MD=0.07,95%CI(0.06,0.08),P<0.00001,I~2=14%],LDL-C[MD=0.10,95%CI(0.05,0.14),P<0.0001,I~2=0%]level.Sensitivity analysis indicated that the results were stable and reliable.Conclusion:1.The main effects of SGLT-2i on lipids in type 2 diabetes patients were decrease TG,and increased TC?HDL-C?LDL-C.2.Different types of SGLT-2i have different effects on various indicators of lipids.