Abstract | OBJECTIVE: As an ever widening array of anti-hyperglycemic agents are now available, the effect of these drugs on lipids is increasingly complex and controversial. The present meta-analysis was designed to clarify the effect of a dual combination of noninsulin anti-hyperglycemic agents on lipids in type 2 diabetes. METHODS: RESULTS: Eighteen studies with a total of 10,222 patients were included. Network meta-analysis suggested that metformin + dipeptidyl peptidase-4 inhibitors (DPP-4) ( LDL cholesterol: -0.19 mmol/L; HDL cholesterol: 0.06 mmol/L; triglycerides: -0.73 mmol/L; total cholesterol: -0.4 mmol/L) and metformin + glucagon-like peptide-1 (GLP-1) agonist ( LDL cholesterol: -0.3 mmol/L; HDL cholesterol: 0.06 mmol/L; triglycerides: -0.64 mmol/L; total cholesterol: -0.5 mmol/L) were associated with relatively larger beneficial effects on the lipid profile among all combinations. Compared with metformin + thiazolidinedione, metformin + GLP-1 agonist (mean difference: -0.38; 95% confidence interval [CI]: -0.66 to -0.10) significantly decreased LDL cholesterol. Metformin + thiazolidinedione showed a larger increase than metformin + sulfonylurea in HDL cholesterol (mean difference: 0.1; 95% CI: 0.01 to 0.21). CONCLUSIONS: The effect of a dual combination of noninsulin anti-hyperglycemic agents on lipids is moderate to small, with metformin + DPP-4 inhibitor and metformin + GLP-1 agonist showing consistent beneficial effects on LDL cholesterol, HDL cholesterol, triglycerides and total cholesterol. Future trials are needed to confirm these findings.
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Authors | Xiaoyu Dai, Hongtao Wang, Zhong Jing, Ping Fu |
Journal | Current medical research and opinion
(Curr Med Res Opin)
Vol. 30
Issue 9
Pg. 1777-86
(Sep 2014)
ISSN: 1473-4877 [Electronic] England |
PMID | 24805140
(Publication Type: Journal Article, Meta-Analysis, Review, Systematic Review)
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Chemical References |
- Biomarkers
- Dipeptidyl-Peptidase IV Inhibitors
- Hypoglycemic Agents
- Lipoproteins, HDL
- Lipoproteins, LDL
- Sulfonylurea Compounds
- Thiazolidinediones
- Triglycerides
- Glucagon-Like Peptide 1
- Metformin
- Cholesterol
- 2,4-thiazolidinedione
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Topics |
- Biomarkers
(blood)
- Cholesterol
(blood)
- Diabetes Mellitus, Type 2
(blood, drug therapy)
- Dipeptidyl-Peptidase IV Inhibitors
(therapeutic use)
- Drug Therapy, Combination
- Glucagon-Like Peptide 1
(agonists)
- Humans
- Hypoglycemic Agents
(therapeutic use)
- Lipoproteins, HDL
(blood)
- Lipoproteins, LDL
(blood)
- Metformin
(therapeutic use)
- Models, Statistical
- Randomized Controlled Trials as Topic
- Sulfonylurea Compounds
(therapeutic use)
- Thiazolidinediones
(therapeutic use)
- Treatment Outcome
- Triglycerides
(blood)
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