针对不同糖尿病前表型的个体对生活方式干预的反应:系统性审查和元分析
Jincheng Rong1, Mandy Ho1, Disheng Zhou1
1School of Nursing, LKS Faculty of Medicine, the University of Hong Kong, Hong Kong, SAR, China.
Diabetes research and clinical practice
|December 6, 2024
概括
生活方式干预有效地降低了患有葡萄糖耐受性损害 (IGT) 的个体的糖尿病发病率,有或没有禁食葡萄糖 (IFG) 损害. 针对隔离失调的禁食葡萄糖 (i-IFG) 进行量身定制的干预是必要的,以预防糖尿病.
科学领域:
- 代谢健康 代谢健康
- 内分泌学 在内分泌学.
- 预防医学 预防医学
背景情况:
- 糖尿病前期的特征是不同的表型,包括孤立的快食葡萄糖受损 (i-IFG),孤立的葡萄糖耐受性受损 (i-IGT) 和结合IFG + IGT.
- 生活方式干预 (LI) 是糖尿病前期管理的基石.
- 了解表型特异性对LIs的反应对于优化糖尿病预防策略至关重要.
研究的目的:
- 评估生活方式干预措施在不同糖尿病前表型的人群中的有效性.
- 评估LIs对糖尿病发病率,糖尿病前期逆转,血糖控制和胰岛素敏感性的影响.
- 根据糖尿病前表型识别LI反应的潜在差异.
主要方法:
- 在主要数据库 (PubMed,Embase,Cochrane图书馆,Web of Science) 进行了系统的文献搜索,直到2023年12月.
- 包括生活方式干预 (饮食和/或体力活动) 的随机对照试验 (RCT) 在患有i-IFG,i-IGT或IFG + IGT的成年人中.
- 进行了随机效应元分析,以综合有关糖尿病发病率,血糖正常,葡萄糖水平和胰岛素抵抗标志物的数据.
主要成果:
- 生活方式干预在i-IGT和联合IFG + IGT表型中显著降低了糖尿病发病率,但在i-IFG中没有.
- 招募IGT (有或没有IFG) 参与者的研究表明,糖尿病发病率降低,血糖正常度增加.
- 在IGT群体中,LIs还导致快速血葡萄糖,2小时血葡萄糖,快速胰岛素和HOMA-IR显著改善.
结论:
- 生活方式干预措施是有效的管理糖尿病前期在个人的葡萄糖耐受性受损,无论是孤立或结合受损的禁食葡萄糖.
- 有必要开发专门针对i-IFG表型的定制生活方式干预措施,以有效地预防发展为2型糖尿病.
- 对表型特定的方法对于最大限度地发挥生活方式干预在糖尿病前期管理中的好处至关重要.
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