生活方式干预对成年糖耐量受损患者血糖影响的系统评价及meta分析

Relationship between lifestyle interventions and glycemic level in adults with impaired glucose tolerance： A systematic review and meta-analysis

目的 探讨生活方式干预对成年糖耐量受损患者血糖的影响.方法 检索MEDLINE（Pub Med）、EMBASE、Science Citation Index （SCI）及Cochrane数据库获取相关文献.以葡萄糖负荷后2h、空腹血糖水平为结局指标.仅限于英文文献.按照纳入和排除标准选择相关研究进行文献质量评价后,以标准化均数差（SMD）表示效应的差异,使用Stata 11.0进行meta分析.结果 共有10篇研究被纳入meta分析.生活方式干预对负荷后2h血糖和空腹血糖影响均有统计学意义（SMD：-0.67,P＜0.01;SMD：-0.33,P＜0.01）,但均存在高异质性.结论 运动锻炼、饮食调节等生活方式干预可能降低糖耐量受损患者的血糖水平.由于研究间的异质性较大,生活方式干预对血糖水平的影响仍需要更多高质量的RCTs研究.

Objective To determine the efficacy of lifestyle interventions in adults with impaired glucose tolerance （IGT）.Methods MEDLINE （Pub Med）,EMBASE,Science Citation Index （SCI）,and Cochrane Database were retrieved for articles about the relations of lifestyle intervention and IGT.Searches were limited to English language publications.The RCTs outcome evaluated in this study included 2 h plasma glucose level and fasting plasma glucose,meta-analysis was carried oat by Stata 11.0 among articles for the inclusion and exclusion criteria.The difference of effects was expressed as standardized mean deviation（SMD）.Results A total of 10 RCTs studies met the inclusion criteria.Lifestyle interventions were associated with a decline in 2 h plasma glucose and fasting plasma glucose level （SMD =-0.67,P〈0.01 ;SMD =-0.33,P〈0.01）,but high heterogeneity was identified in this meta-analysis.Conclusion Physical,dietary and both combined interventions can reduce 2-h plasma glucose and fasting plasma glucose levels in adults with impaired glucose tolerance.As high heterogeneity was identified in this meta-analysis,more high quality research is needed.