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Objective To evaluate the efficacy and safety of treatment of diabetic nephropathy pioglitazone. Method for computer retrieval of PUBMED, EMBASE, The Cochrane Library, Chinese bio-medical literature database, China Academic Journal, Time As of December 2010, included in topiramate grid column ketone treatment of diabetic nephropathy in the randomized controlled trial, according to the inclusion and exclusion criteria selected literature conducted quality evaluation use Revman5.0 software to extract data Meta-analysis. Results A total of eight randomized controlled trial (RCT), including 449 cases of patients with diabetic nephropathy, which test group to use pioglitazone group 233 cases, 216 cases of the control group. Meta-analysis results show that, in terms of efficacy (1) phase III diabetic nephropathy (DN), the pioglitazone group than in the conventional treatment group can more effectively improve urinary albumin excretion rate (UAER) [P lt; 0.00001, SMD = 93.93,95 % CI (86.44,101.41)]; effective improvement of microalbuminuria the proteinuria (MAU) [P lt; 0.0001, SMD = 18.58,95% CI (9.94,27.23)]. (2) Phase III DN pioglitazone serum creatinine (SCR) and creatinine clearance rate (CCR) to improve the situation is not significant, the combined effect of the amount, respectively [P = 0.52, SMD = 1.17,95% CI (-2.36,4.71 (3) IV period DN, pioglitazone group than in the conventional treatment group can be more effective to improve the 24-hour urine protein (UPE) [P lt; 0.00001, SMD = 1.21, 95% CI (1.05,1.37)]. (4) pioglitazone can significantly improve insulin resistance, insulin sensitivity index (ISI) combined amount of [P lt; 0.00001, SMD = 1.11, 95% CI (1.01,1.22)]. (5) pioglitazone can reduce low-density lipoprotein (LDL-C), triglycerides (TG), total cholesterol (TC), the combined effect size, respectively [P = 0.0006, SMD = 0.82, 95% CI (0.35, Also improved high-density lipoprotein (HDL), the combined amount of [P = 0. 007, SMD = 0.09,95% CI (0.02,0.16)]. (6) Safety aspects 8 Study 2 reported adverse reactions case 6 not mentioned adverse reactions. Two studies reported adverse reactions, a study of hypoglycemia, weight gain and other adverse reactions. The remaining one study reported any adverse reactions occur. Since all tests for up to 24 weeks, it was unable to evaluate the efficacy and safety of long-term treatment. Conclusion pioglitazone can reduce the discharge of urine albumin and total protein, and slow the progress of diabetic nephropathy. Pioglitazone improve insulin resistance, thereby indirectly protect the kidneys regulate glucose and lipid metabolism. Need more long-term, larger studies to further assess the the pioglitazone security.
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