生酮饮食对2型糖尿病患者长期疗效的随机对照研究荟萃分析

Long-term effect of ketogenic diet in patients with type 2 diabetes:A meta-analysis of randomized controlled trials

目的分析生酮饮食对2型糖尿病长期血糖、体质量、血压、血脂管理的影响。方法通过计算机检索Medline、Embase、Ovid、Cochrane数据库,检索时间从建库开始至2019年10月,利用荟萃分析方法评价生酮饮食在2型糖尿病长期治疗(≥12个月)中的作用。结果检索数据库后最终纳入5项随机对照研究(RCT)进行荟萃分析,纳入受试者531例。荟萃分析显示,生酮饮食组(n=267)与非生酮饮食组(n=264)体质量、糖化血红蛋白(HbA1c)、收缩压、舒张压水平比较差异无统计学意义;生酮饮食组平均甘油三酯水平较非生酮饮食组低0.24 mmol/L(95%CI:-0.38~-0.10),差异有统计学意义(P<0.05);生酮饮食组(n=241)与非生酮饮食组(n=238)LDL-c水平比较差异无统计学意义。结论在2型糖尿病的长期饮食治疗方案中,尚不能证明生酮饮食疗效优于非生酮饮食。

Objective To analyze the influence of ketogenic diet on long-term blood glucose, body mass, blood pressure and blood lipid management of type 2 diabetes. Methods A computer search of Medline, Embase, Ovid, and Cochrane databases, starting from the establishment of the database to October 2019, using meta-analysis to evaluate the role of ketogenic diet in the long-term treatment of type 2 diabetes(≥12 months). Results After searching the database, 5 randomized controlled trials(RCTs) were finally included for meta analysis, and 531 subjects were included. Meta analysis revealed that the difference in body mass, glycated hemoglobin A1 c(HbA1 c), systolic pressure and diastolic pressure was not statistically significant between ketogenic diet group(n=267) and non-ketogenic diet group(n=264);the average triglyceride level of the subjects in the ketogenic diet group was 0.24 mmol/L lower than that of non-ketogenic diet group(95%CI:-0.38 to-0.10), the difference was statistically significant(P<0.05);there was no significant difference in the level of LDL-c between ketogenic diet group(n=241) and non-ketogenic diet group(n=238). Conclusion In long-term treatment of type 2 diabetes, it is not yet proven that ketogenic diet has better effect than non-ketogenic diet.