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Meta-Analysis
. 2016 Sep 6:6:32649.
doi: 10.1038/srep32649.

Alpha-glucosidase inhibitors and hepatotoxicity in type 2 diabetes: a systematic review and meta-analysis

Longhao Zhang  1 , Qiyan Chen  2 , Ling Li  1 , Joey S W Kwong  1 , Pengli Jia  1 , Pujing Zhao  1 , Wen Wang  1 , Xu Zhou  1 , Mingming Zhang  1 , Xin Sun  1
Affiliations
Meta-Analysis

Alpha-glucosidase inhibitors and hepatotoxicity in type 2 diabetes: a systematic review and meta-analysis

Longhao Zhang et al. Sci Rep. .

Abstract

Alpha-glucosidase inhibitors (AGIs) was reported to be associated with several rare adverse hepatic events, but with inconsistent results. We aimed to investigate the risk of hepatotoxicity associated with the use of AGIs in patients with type 2 diabetes mellitus (T2DM), and performed a systematic review and meta-analysis. Fourteen studies (n = 2881) were eligible, all of which were RCTs. Meta-analysis of data regarding elevation of more than 3-fold the upper limit of normal (ULN) of AST and ALT showed statistically significant differences between AGIs treatment versus control (OR 6.86, 95% CI 2.50 to 18.80; OR 6.48, 95% CI 2.40 to 17.49). Subgroup analyses of elevation of more than 1.8-fold ULN of AST and ALT by dose of AGIs showed differential effects on AST and ALT (AST: OR 0.38 vs 7.31, interaction P = 0.003; ALT: OR 0.32 vs 4.55, interaction p = 0.02). Meta-analysis showed that AGIs might increase the risk of hepatotoxicity, and higher dose appeared to be associated with higher risk of hepatotoxicity. However, the evidence is limited with surrogate measures (i.e. ALT and AST), and no clinically important adverse events were observed.

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Figures

Figure 1
Figure 1. Flow chart of article selection.
*Data form ClinicalTrial.gov.
Figure 2
Figure 2. The subgroup analyses by the varying doses of AGIs on the elevations 1.8-fold the upper limit of normal of AST levels.
Figure 3
Figure 3. Alpha-glucosidase inhibitors on the elevations 3-fold the upper limit of normal of AST levels in patients with type 2 diabetes.
Figure 4
Figure 4. The subgroup analyses by the varying doses of AGIs on the elevations 1.8-fold the upper limit of normal of ALT levels.
Figure 5
Figure 5. Alpha-glucosidase inhibitors on the elevations 3-fold the upper limit of normal of ALT levels in patients with type 2 diabetes.
See this image and copyright information in PMC

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