Efficacy of dipeptidyl‐peptidase‐4 inhibitors and impact on β ‐cell function in A sian and C aucasian type 2 diabetes mellitus patients: A meta‐analysis在亚洲人和白种人的2型糖尿病患者中DPP‐4抑制剂的疗效及对 β 细胞功能的影响：一项meta分析

Background This work aimed to compare the efficacy of dipeptidyl peptidase‐ IV ( DPP ‐4) inhibitors and their impact on β ‐cell function in A sian and C aucasian patients with type 2 diabetes mellitus. Methods Databases were systematically searched and qualifying studies that compared DPP ‐4 inhibitors with other antidiabetic medications in type 2 diabetes were included. Results A total of 68 studies were included in the meta‐analysis. Comparison of DPP ‐4 inhibitors with placebo in A sian patients showed a decrease in glycosylated hemoglobin ( HbA 1c ) favoring DPP ‐4 inhibitors (weighted mean difference [ WMD ], −0.81%; 95% confidence interval [ CI ], −0.95% to −0.68%; P  < 0.001). Comparison of HbA 1c changes between Asian and Caucasian patients showed a significant between‐group difference of −0.18% (95% CI , −0.32% to −0.04%; P  = 0.011) when compared with placebo. In A sian patients, the homeostatic model assessment for β ‐cell function ( HOMA ‐ β ) was increased with DPP ‐4 inhibitors compared with placebo ( WMD , 7.90; 95% CI , 4.29 to 11.51; P  < 0.001), although to a lesser extent in C aucasian patients. Comparisons between A sian and C aucasian patients showed a significant between‐group difference of −4.97 (95% CI , −9.86 to −0.09; P  = 0.046) compared with placebo. Body weight increase with DPP ‐4 inhibitors compared with placebo was comparable in Asian and Caucasian studies ( WMD , 0.37 kg and 0.45 kg and 95% CI , 0.04–0.69 and 0.27–0.62, respectively). Conclusions The glucose‐lowering efficacy of DPP ‐4 inhibitors was greater in A sian patients than in C aucasian patients, although the effect on β ‐cell function was inferior in A sian patients. The effect of DPP ‐4 inhibitors on insulin resistance and body weight in A sian patients was comparable with that observed in C aucasian patients.