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. 2024 Feb 1:15:1333624.
doi: 10.3389/fendo.2024.1333624. eCollection 2024.

Selective sodium-glucose cotransporter-2 inhibitors in the improvement of hemoglobin and hematocrit in patients with type 2 diabetes mellitus: a network meta-analysis

Yuanyuan Luo #  1 , Ruojing Bai #  2 , Wei Zhang  1 , Guijun Qin  1
Affiliations

Selective sodium-glucose cotransporter-2 inhibitors in the improvement of hemoglobin and hematocrit in patients with type 2 diabetes mellitus: a network meta-analysis

Yuanyuan Luo et al. Front Endocrinol (Lausanne). .

Abstract

Objective: To compare the effects of different selective sodium-glucose cotransporter-2 inhibitors (SGLT2i) on hemoglobin and hematocrit in patients with type 2 diabetes mellitus (T2DM) with a network meta-analysis (NMA).

Methods: Randomized controlled trials (RCTs) on SGLT2i for patients with T2DM were searched in PubMed, Embase, Cochrane Library, and Web of Science from inception of these databases to July 1, 2023. The risk of bias (RoB) tool was used to evaluate the quality of the included studies, and R software was adopted for data analysis.

Results: Twenty-two articles were included, involving a total of 14,001 T2DM patients. SGLT2i included empagliflozin, dapagliflozin, and canagliflozin. The NMA results showed that compared with placebo, canagliflozin 100mg, canagliflozin 300mg, dapagliflozin 10mg, dapagliflozin 2mg, dapagliflozin 50mg, dapagliflozin 5mg, empagliflozin 25mg, and dapagliflozin 20mg increased hematocrit in patients with T2DM, while canagliflozin 100mg, canagliflozin 200mg, canagliflozin 300mg increased hemoglobin in patients with T2DM. In addition, the NMA results indicated that canagliflozin 100mg had the best effect on the improvement of hematocrit, and canagliflozin 200mg had the best effect on the improvement of hemoglobin.

Conclusion: Based on the existing studies, we concluded that SGLT2i could increase hematocrit and hemoglobin levels in patients with T2DM, and canagliflozin 100mg had the best effect on the improvement of hematocrit, while canagliflozin 200mg had the best effect on the improvement of hemoglobin.

Systematic review registration: https://www.crd.york.ac.uk/PROSPERO/#loginpage, identifier PROSPERO (CRD42023477103).

Keywords: hematocrit; hemoglobin; network meta; selective sodium-glucose cotransporter-2 inhibitor; type 2 diabetes mellitus.

PubMed Disclaimer

Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Flow chart of literature search.
Figure 2
Figure 2
Risk assessment of literature bias. The quality assessment for each bias risk item is presented as a percentage. “+” means low risk and “?” means unclear.
Figure 3
Figure 3
Risk assessment of literature bias. Quality assessment of each bias risk item for each study. Each color represents a difference in the risk of bias: green represents low risk of bias, yellow represents unclear risk, and red represents high risk of bias.
Figure 4
Figure 4
Meta-analysis of hematocrit (A): Network diagram; Network graphs of all the drug agents included in the study. The width of the lines is proportional to the number of trials comparing each pair of treatments. The sizes of the circles are proportional to the number of trials using this intervention. (B): surface under the cumulative ranking curve, (C): Forest map of the effects drugs on the regulation of hematocrit).
Figure 5
Figure 5
Meta-analysis of hemoglobin (A): Network diagram; Network graphs of all the drug agents included in the study. The width of the lines is proportional to the number of trials comparing each pair of treatments. The sizes of the circles are proportional to the number of trials using this intervention. (B): surface under the cumulative ranking curve, (C): Forest map of the effects drugs on the regulation of hemoglobin).
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References

    1. Faizan M, Sarkar A, Singh MP. Type 2 diabetes mellitus augments Parkinson’s disease risk or the other way around: Facts, challenges and future possibilities. Ageing Res Rev (2022) 81:101727. doi: 10.1016/j.arr.2022.101727 - DOI - PubMed
    1. Nauck MA, Wefers J, Meier JJ. Treatment of type 2 diabetes: challenges, hopes, and anticipated successes. Lancet Diabetes Endocrinol (2021) 9(8):525–44. doi: 10.1016/S2213-8587(21)00113-3 - DOI - PubMed
    1. Sun H, Saeedi P, Karuranga S, Pinkepank M, Ogurtsova K, Duncan BB, et al. . IDF Diabetes Atlas: Global, regional and country-level diabetes prevalence estimates for 2021 and projections for 2045. Diabetes Res Clin Pract (2022) 183:109119. doi: 10.1016/j.diabres.2021.109119 - DOI - PMC - PubMed
    1. Olum R, Bongomin F, Kaggwa MM, Andia-Biraro I, Baluku JB. Anemia in diabetes mellitus in Africa: A systematic review and meta-analysis. Diabetes Metab Syndr (2021) 15(5):102260. doi: 10.1016/j.dsx.2021.102260 - DOI - PubMed
    1. Al-Khoury S, Afzali B, Shah N, Thomas S, Gusbeth-Tatomir P, Goldsmith D, et al. . Diabetes, kidney disease and anaemia: time to tackle a troublesome triad? Int J Clin Pract (2007) 61(2):281–9. doi: 10.1111/j.1742-1241.2006.01259.x - DOI - PubMed

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