Reappraisal of Metformin Efficacy in the Treatment of Type 2 Diabetes A Meta-Analysis of Randomised Controlled Trials 英文参考文献.docVIP

ReappraisalofMetforminEfficacyintheTreatmentof Type2Diabetes:AMeta-AnalysisofRandomised ControlledTrials Re′myBoussageon1,Ire`neSupper1,TheodoraBejan-Angoulvant2,3,NadirKellou1,MichelCucherat4,5, Jean-PierreBoissel4,5,BehrouzKassai4,5,6,7,AlainMoreau1,Franc?oisGueyffier4,5,6,7, CatherineCornu4,5,6,7 * 1 Department of General Medicine, Universite′ Claude Bernard Lyon 1, Lyon, France,2 Service de Pharmacologie Clinique, Centre Hospitalier Re′gional et Universitaire de Tours, France,3 UMR 7292, CNRS, Universite′ Franc?ois Rabelais, Tours, France, 4 UMR 5558, CNRS, Laboratoire de Biome′trie et Biologie E′volutive, Villeurbanne, France, 5 Universite′ Claude Bernard Lyon 1, Lyon, France,6 Clinical Investigation Centre, INSERM CIC201, Lyon, France,7 Department of Clinical Pharmacology, Hospices Civils de Lyon, Lyon, France Abstract Background: The UK Prospective Diabetes Study showed that metformin decreases mortality compared to diet alone in overweight patients with type 2 diabetes mellitus. Since then, it has been the first-line treatment in overweight patients with type 2 diabetes. However, metformin-sulphonylurea bitherapy may increase mortality. Methods and Findings: This meta-analysis of randomised controlled trials evaluated metformin efficacy (in studies of metformin versus diet alone, versus placebo, and versus no treatment; metformin as an add-on therapy; and metformin withdrawal) against cardiovascular morbidity or mortality in patients with type 2 diabetes. We searched Medline, Embase, and the Cochrane database. Primary end points were all-cause mortality and cardiovascular death. Secondary end points included all myocardial infarctions, all strokes, congestive heart failure, peripheral vascular disease, leg amputations, and microvascular complications. Thirteen randomised controlled trials (13,110 patients) were retrieved;