生活方式干预对糖耐量受损人群患糖尿病风险影响的Meta分析-现代医学

生活方式干预对糖耐量受损人群患糖尿病风险影响的Meta分析

作者：宋歌

单位：上海市杨浦区安图医院护理部

分类号：

出版年·卷·期（页码）：2014·42·第六期（622-627）

摘要：

目的：采用循证医学Meta分析方法定量评价生活方式干预对糖耐量受损（Impaired Glucose Tolerance, IGT）人群患糖尿病风险的影响。方法：计算机检索PubMed、EMBASE、CNKI和万方等数据库，全面收集有关IGT人群生活方式干预的随机对照试验，数据运用STATA 12.0软件进行汇总分析，采用相对危险值（relative risk, RR）及其95%可信区间（95% confidence interval，95%CI）描述关联。结果：严格根据纳入和排除标准，最终共纳入16项研究，共包括8571例IGT患者，其中干预组4525例，对照组4046例。Meta分析结果显示：随访后结束后，干预组IGT人群的糖尿病发病率显著低于对照组（RR = 0.54, 95%CI: 0.49-0.60, P < 0.001）。根据种族进行亚组分析显示：亚洲人群与高加索人群干预组IGT人群的糖尿病发病率均显著低于对照组；根据生活干预方式进行亚组分析时，结果显示各种干预治疗均与糖尿病发病率显著相关，饮食、运动及饮食加运动干预组的糖尿病发病率较对照组分别下降48%，32%及35%。结论：现有证据表明，IGF人群进行生活方式干预能有效的降低糖尿病的发病率。

Objective: The objectives of this study are to assess the effects of lifestyle interventions on the prevention of diabetes in patients with impaired glucose tolerance (IGT). Methods: The PubMed, EMBASE, CNKI and Wanfang databases were searched. Statistical analyses were performed using STATA 12.0 software. Results were described as relative risk (RR) with 95% confidence intervals (CI). Results: A total of 16 randomized controlled trials (RCTs) with a combined cohort size of 8571 IGT participants were identified. Overall, our meta-analysis suggests the usefulness of lifestyle interventions in preventing diabetes in patients with IGT (RR = 0.54, 95%CI: 0.49-0.60, P < 0.001), and similar findings were observed in both Caucasian population and Asian population. We also performed subgroup analysis by lifestyle interventions, and found that compared with control group, diet, exercise, and diet plus exercise can result in a reduction of around 48%, 32% and 35% in diabetes incidence, respectively. Conclusion: This meta-analysis illustrated that lifestyle interventions can have a beneficial effect on the incidence of diabetes in patients with IGT.

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