糖调节受损各亚型向糖尿病进展年转换率的meta分析

Meta-analysis of annual progression rate of each subtype of impaired glucose tolerance during developing course towards diabetes

目的 系统评价糖调节受损（IGR）各亚型向糖尿病进展的年转化率，为IGR人群早期筛查和干预的必要性提供较为客观的依据。方法 计算机检索PubMed、EMbase、The Science Citation Index databases、Cochrane图书馆、CBM和CNKI，结合手工检索，查找与空腹血糖受损（IFG）、糖耐量减退（IGT）、单纯性空腹血糖受损（I-IFG）、单纯性糖耐量减退（I-IGT）和混合性糖调节受损（CGI）相关的随机及非随机对照试验，按照纳入与排除标准筛选文献、提取资料和评价纳入研究的方法学质量，采用RevMan 5.0软件进行meta分析。结果 共纳入13项研究。Meta分析结果显示：向糖尿病进展的年转化率，IGT组为正常对照组的7.18倍（95%CI 3.70～13.94，P〈0.000 01），IFG组为正常对照组的4.29倍（95%CI 2.29～8.03, P〈0.000 01），I-IFG组为正常对照组的5.94倍（95%CI 3.87～9.14, P〈0.000 01），I-IGT组为正常对照组的9.55倍（95%CI 6.55～13.94, P〈0.000 01），CGI组为正常对照组的12.96倍（95%CI 7.09～22.69, P〈0.000 01）。结论 IGR各亚型向糖尿病进展的年转化率为5%～10%, IGT和I-IGT的进展率略高于IFG和I-IFG, 且随着观察时间的延长，各亚型进展率呈逐渐降低趋势。

Objective To systematically evaluate the annual progression rate of each subtype of impaired glucose tolerance （IGR） during the course of developing towards diabetes and provide the objective proof for early screening and intervention of IGT. Methods Random and non-random control studies relevant to impaired fasting glucose （IFG）, impaired glucose tolerance （IGT）, isolated-impaired fasting glucose （I-IFG）, isolated-impaired glucose tolerance （I-IGT）, and combined glucose intolerance （CGI） were retrieved form the PubMed, EMbase, Science Citation Index databases, Cochrane Library, CBMdisc, and CNKI by computer and manual retrievals. Papers were screened according to the inclusion and exclusion criteria. Data was abstracted and the methodology quality was assessed. The RevMan 5.0 software was adopted to conduct the meta-analysis. Results Thirteen studies were included. The results of meta-analysis showed that the annual progression rate during the course of developing towards diabetes of the IGT group, IFG group, I-IFG group, I-IGT group, and CGI group was 7.18 （95%CI 3.70-13.94，P〈0.000 01）, 4.29 （95%CI 2.29-8.03, P〈0.000 01）, 5.94 （95%CI 3.87-9.14, P〈0.00001）, 9.55 （95%CI 6.55-13.94, P〈0.000 01）, and 12.96 （95%CI 7.09-22.69, P〈0.000 01） times of that of the control group. Conclusion The annual progression rate of each subtypes of IGR during the course of developing towards diabetes is 5%-10% and the progression rates of IGT and I-IGT are slightly higher than those of IFG and I-IFG. With the extension of observation time, the annual progression rate of each subtype gradually decreases.