• Rev Invest Clin · Oct 2020

    Effects of Incretin-based Therapy on High-sensitivity C-reactive Protein in Patients with Type 2 Diabetes: A Systematic Review and Meta-Analysis.

    • Yucheng Wu, Yu Lu, Shufang Yang, and Qingqing Zhang.
    • Department of Cardiology, Taizhou People's Hospital, Taizhou, Jiangsu, China.
    • Rev Invest Clin. 2020 Oct 21; 73 (5).

    BackgroundRecently, studies had shown that incretin-based therapies could reduce the levels of pro-inflammatory markers. The data on the effects of incretin-based therapies on serum high-sensitivity C-reactive protein (hs-CRP) in type 2 diabetes (T2DM) were inconsistent.ObjectiveThe objective of the study was to assess the effects of incretin-based therapies on hs- CRP in patients with T2DM by meta-analysis.MethodsWe searched PubMed, EMBASE, the Cochrane Collaboration Library, and Web of Science to identify the eligible randomized clinical trials until August 2019. The pooled standard mean differences (SMD) were calculated by random-effects model using STATA 11.0.ResultsTwenty-five studies with 28 randomized controlled trials were finally included into the meta-analysis. Meta-analysis revealed a significant reduction in hs-CRP following treatment with incretin-based regimens compared to controls (SMD = -0.452, p < 0.001). Subgroup analysis of different class of incretinbased drugs showed that therapy with both dipeptidyl peptidase 4 inhibitors (DPP-4Is, SMD = -0.338, p = 0.026) and glucagonlike peptide 1 receptor agonists (GLP-1 RAs, SMD = -0.544, p = 0.003) caused significant reductions in hs-CRP. Besides, there was a significant reduction in hs-CRP with an intervention duration more than 24 weeks (SMD = -0.465, p = 0.001), while no significant difference with < 24 weeks. Meta-regression analyses showed that better glycemic control and more body mass index (BMI) decline were associated with hs-CRP reduction after incretin-based therapies.ConclusionsThis meta-analysis suggests that incretin-based therapies, both GLP-1 RAs and DPP-4Is, can cause a significant reduction in hs-CRP in patients with T2DM, which is related to long intervention duration, better glycemic control, and more BMI decline.

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