Lifestyle Interventions for Adults with Impaired Glucose Tolerance: A Systematic Review and Meta-Analysis of the Effects on Glycemic Control
Lifestyle Interventions for Adults with Impaired Glucose Tolerance: A Systematic Review and Meta-Analysis of the Effects on Glycemic Control
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DOI：
10.2169/internalmedicine.54.2745
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发表时间：
2015-01-01
影响因子：
1.2
通讯作者：
Xu, Guo-Zhang
中科院分区：
文献类型：
--
作者：
Gong, Qing-Hai;Kang, Ju-Fang;Xu, Guo-Zhang
目的以往的Meta分析表明，生活方式的改变可以降低2型糖尿病患者的血糖水平，但血糖水平的改变对糖耐量受损（IGT）的影响仍存在争议。因此，这篇综述旨在确定生活方式干预的疗效与IGT.Methods成人，我们搜索了Medline，科克伦图书馆，EMBASE和科学引文索引数据库和参考文献列表中的文章。两名独立的评审员提取了数据并评估了纳入研究的质量;共有9项随机对照试验符合纳入标准。此外，我们测试了试验异质性，并使用随机效应模型计算了合并效应大小。结果总体干预措施与2小时血糖水平下降相关[标准化平均差异（SMD）-0.56; 95%置信区间（CI），-1.01至-0.10; I-2，96.6%]。此外，与对照组受试者相比，饮食干预（SMD-0. 53; 95% CI-0. 77至-0. 28）和身体干预（SMD-0. 42; 95% CI-0. 63至-0. 20）均与2小时血糖水平下降相关。总体干预与空腹血糖（FPG）水平下降相关（SMD-0. 27; 95% CI-0. 38至-0. 15; I-2 = 47. 1%）。此外，物理干预（SMD -0.25; 95% CI -0.44至-0.05）和饮食和身体干预联合均与FPG水平降低相关。（SMD-0.28; 95% CI -0.44至-0.12）结论基于身体或饮食干预或两者兼而有之的生活方式改变与IGT患者2小时血糖和FPG水平的改善。
Objective Previous meta-analyses have demonstrated that lifestyle modification can reduce the blood glucose levels in patients with type 2 diabetes, although the effects of changes in the blood glucose level on impaired glucose tolerance (IGT) remain controversial. This review therefore aimed to determine the efficacy of lifestyle interventions in adults with IGT.Methods We searched the Medline, Cochrane Library, EMBASE and Science Citation Index databases and reference lists of the included articles. Two independent reviewers extracted the data and assessed the quality of the included studies; a total of nine randomized controlled trials met the inclusion criteria. In addition, we tested for trial heterogeneity and calculated the pooled effects size using the random effects model.Results The overall interventions were associated with a decline in the 2-hour plasma glucose levels [standardized mean differences (SMD) -0.56; 95% confidence interval (CI), -1.01 to -0.10; I-2, 96.6%]. Moreover, dietary intervention (SMD -0.53; 95% CI -0.77 to -0.28) and physical intervention (SMD -0.42; 95% CI -0.63 to -0.20) were each associated with a decline in the 2-hour plasma glucose levels compared with that observed in the control participants. The overall interventions were associated with a decline in the fasting plasma glucose (FPG) levels (SMD -0.27; 95% CI -0.38 to -0.15; I-2 = 47.1%). In addition, physical intervention (SMD -0.25; 95% CI -0.44 to -0.05) and combined dietary and physical intervention were each associated with a decreased FPG level (SMD -0.28; 95% CI -0.44 to -0.12) compared with that observed in the control participants.Conclusion Lifestyle modification based on physical or dietary interventions or both is associated with improvements in the 2-hour plasma glucose and FPG levels in IGT patients.