生活方式干预对血脂异常患者血脂指标影响的Meta分析

Effect of lifestyle intervention on indexes of patients with dyslipidemia ： a meta-analysis

目的评价生活方式干预对血脂异常患者血脂指标水平的影响。方法检索中国知网、万方医学网、维普网、PubMed, Web of Science, EBSCO, EMbase, the Cochrane Library. Clinical Trials、MEDLINE等数据库，检索词为血脂异常、生活方式干预、饮食、运动、高血脂、血脂、戒烟、不饱和脂肪酸、lifestyle intervention, lifestyle, diet. physical activity, dyslipidemia, hypercholesterolemia,lipid, quit smoking, drinking limits, wholegrains, monounsaturated fatty acids, low-fat diet, Low glycemic diet,plant sterols等。检索生活方式干预对血脂异常患者血脂指标水平影响相关的随机对照试验（RCT）研究并根据纳入排除标准筛选，提取资料后采用RevMan5．3软件进行Meta分析。结果纳入19篇文献，共2294例样本，包括干预组1170例，对照组1124例。分析结果显示，总胆固醇加权均方差（WMD）=-0．61（95％CI：-0．84--0．38，P〈0．01）；三酰甘油WMD=-0．28（95％CI：-0．42--0．15，P〈0．01）；低密度脂蛋白胆固醇WMD=-0．45（95％CI：-0．72--0．18，P〈0．01）。干预组指标值均低于对照组，差异有统计学意义。高密度脂蛋白胆固醇WMD=-0．05（95％CI：-0．22-0．12，P〉0．05）。结论生活方式干预能降低血脂异常患者的胆固醇、三酰甘油和低密度脂蛋白胆固醇水平，但升高高密度脂蛋白胆固醇作用不显著。

Objective To evaluate the effect of lifestyle intervention on the indexes of patients with dyslipidemia. Methods CNKI, Wanfang Database, VIP, PubMed, Web of Science, EBSCO, EMbase,the Cochrane Library, Clinical Trials, MEDLINE were retrieved. The search terms included lifestyle intervention, lifestyle, diet, physical activity, dyslipidemia, hypereholesterolemia, lipid, low fat diet, plant sterols,low-glycemic index （GI） diets, mono-unsaturated fatty acids. Articles on randomized controlled trials（RCTs）to study the effect of lifestyle intervention on the indexes of patients with dyslipidemia were screened according to inclusion and exclusion criteria. Meta-analyses were conducted by using RevMan 5.3 software after extracting data. Results 19 articles were internalized,including 2 294 patients （intervention group, n = 1,170） and （ control group, n = 1, 124）. According to the results of intervention group versus control group, total cholesterol of weighted mean difference （WMD）was （ 0.61,95%CI：-0.84- -0.38,P〈0.01）,triglycerideofWMDwas（-0.28,95%CI：-0.42-0.15） ,P〈0.01） ,low-density lipoprotein cholesterol of WMD was（-0.45,95%CI： -0.72-0.18,P〈0.01）, （all P〈0.01）, with significantly lower WMD in intervention group than in control group. The high-density lipoprotein cholesterol of WMD was （ -0.05,95% CI： -0.22-0.12, P = 0.59） ,the difference was not significant. Conclusions Lifestyle intervention improves serum levels of total cholesterol, triglyceride and low-density lipoprotein cholesterol for dyslipidemia patients, but its effect on high-density lipoprotein cholesterol is not significant.