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生活方式改变对糖尿病前期人群血糖及相关指标的Meta分析

来自:中国糖尿病杂志  编辑:李琳 唐建平 范惠芸 杨建军 陶秀娟 李|点击数:|2014-07-30

糖尿病临床研究

  【摘要】 目的 评价生活方式对糖尿病前期人群血糖及相关指标干预的有效性及安全性。 方法 全面收集国内外1966~2013年发表的相关文献,采用Revman 5.0软件进行数据合并和敏感性分析,GRADE系统进行证据质量评价。 结果 纳入16项随机对照试验(n=3469),Meta分析结果显示,与对照组相比,生活方式干预组糖尿病发生率(RR:0.61,95%CI:0.52~0.71,P<0.00001),FPG(WMD:-0.33 mmol/L,95%CI:-0.53~-0.13),2 hPG(WMD:-0.74 mmol/L,95%CI:-1.38~-0.11),HbA1c(WMD:-0.30%,95%CI:-0.49~-0.11)及BMI均降低(WMD:-1.03 kg/m2,95%CI:-1.48~-0.58)。 结论 生活方式的改变对糖尿病前期人群能防止或延缓糖尿病的发生。

  【关键词】 糖尿病前期;生活方式;Meta分析;系统评价;随机对照试验

  【Abstract】 Objective To evaluate the efficacy and safety of lifestyle interventions on blood sugar and relevant indicators in people with Pre-diabetes of. Methods Relevant studies reported in domestic and international databases including MEDLINE,EMBASE,Web of Science,The Cochrane Library,CBM,China National Knowledge Infrastructure (CNKI) and Chinese VIP database from 1966 to June 2013 were collected. The data was extracted by two authors independently. Meta-analysis was carried out using Review manager 5.0 and GRADEpro 3.6 software was used to conduct quality evaluation of evidence. Fixed-effects models or random-effects models were used to pool the summary relative risk (RR) and weighted mean difference (WMD). Results 16 literatures were selected for randomized controlled trial (n=3469) based on our including and excluding standards. Meta-analysis showed that the incidence of diabetes,fasting blood glucose,postprandial plasma glucose,hemoglobin A1c,body mass index and waist circumference in lifestyle interventions group significantly reduced, compared with control group. The summary relative risk (RR) or weighted mean difference (WMD) and 95% confidence interval were as followings:incidence of diabetes(RR:0.61,95%CI:0.52~0.71,P<0.00001);FPG(WMD:-0.33 mmol/L,95%CI:-0.53~-0.13 );2 hPG(WMD:-0.74 mmol/L,95%CI:-1.38~-0.11);HbA1c(WMD:-0.30%,95%CI:-0.49~-0.11);BMI(WMD:-1.03 kg/m2,95%CI:-1.48~-0.58); waist circumference(WMD:-1.35cm,95%CI:-2.34~-0.35 ). Conclusion Lifestyle interventions may be a useful tool in preventing diabetes for people with pre-diabetes and was effective for reducing Glucose.

  【Keywords】Prediabetic State;Lifestyle modification;Meta-analysis; Systematic review;Randomized controlled trial

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