用于预测早期1型糖尿病儿童疾病进展的测试方法:系统性审查和元分析
Rabbi Swaby1, Kruthika Narayan2,3, Claire Scudder1
1Centre for Human Genetics, Nuffield Department of Medicine, NIHR Oxford Biomedical Research Centre, University of Oxford, Oxford, UK.
概括
口服葡萄糖耐受性测试 (OGTT) 和HbA1c有效预测儿童和年轻人的1型糖尿病进展. 对于持续血糖监测 (CGM) 和其他测试,需要更多的研究.
科学领域:
- 内分泌学 在内分泌学.
- 儿科 儿科 儿科
- 代谢疾病 代谢疾病
背景情况:
- 目前对儿童和青少年1型糖尿病早期监测的指导方针 (CYP) 严重依赖于专家的共识.
- 需要基于证据的预测测试来监测这一群体的疾病进展.
研究的目的:
- 系统地审查和元分析预测早期1型糖尿病的CYP疾病进展的测试证据.
- 确定可靠的生物标志物,用于监测向第3阶段1型糖尿病的过渡.
主要方法:
- 我们对PubMed,Cochrane Central,Ovid Embase和Scopus进行了系统的搜索.
- 风险比率 (HR) 对于进展到第3阶段1型糖尿病的风险比率使用随机效应模型对具有≥2小岛自身抗体的CYP (≤18年) 进行了聚合.
- 使用QUADAS-2工具评估了偏差风险.
主要成果:
- 分析了包括6866个CYP在内的34项研究,其中30%的患者在5年的中位数内进展到3期糖尿病.
- 预测进展的测试包括OGTT的禁食葡萄糖 (HR 1.40),2小时葡萄糖 (HR 3.19),M120 (HR 6.43),Index60 (HR 3.12),以及HbA1c (HR 1.40).
- 持续血糖监测 (CGM) 和其他测试的证据是不确定的.
结论:
- 口服葡萄糖耐受性测试 (OGTT),包括M120和Index60,以及HbA1c是CYP中第3阶段1型糖尿病进展的有效预测剂.
- 需要进一步的研究来验证像CGM这样的测试在这个人口群体中的预测效用.
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