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膳食限制高血压(DASH)饮食对 2 型糖尿病发病风险的影响:基于对照临床试验的系统评价和荟萃分析。

Effects of Dietary Approaches to Stop Hypertension (DASH) diet on some risk for developing type 2 diabetes: a systematic review and meta-analysis on controlled clinical trials.

机构信息

Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.

出版信息

Nutrition. 2013 Jul-Aug;29(7-8):939-47. doi: 10.1016/j.nut.2012.12.021. Epub 2013 Mar 6.

Abstract

OBJECTIVE

Type 2 diabetes is a major public health problem. The Dietary Approaches to Stop Hypertension (DASH) eating pattern may contribute to managing risk factors of type 2 diabetes. The objective of this study was to conduct a systematic review and meta-analysis on randomized controlled trials (RCTs) that examine the effects of DASH diet consumption on the indices of glycemic control such as fasting blood glucose (FBG), serum fasting insulin level, and Homeostatic Model Assessment insulin resistance (HOMA-IR).

METHODS

We searched Pubmed, EMBASE, Science direct, ISI web of science, and Google Scholar for RCTs until July 2012. In total we found 20 articles that examine the effect of DASH diet on FBG (n = 9), fasting insulin (n = 7) and HOMA-IR (n = 4) met the inclusion criteria, respectively.

RESULTS

Meta-analysis showed that the DASH diet can significantly reduce fasting insulin concentration (mean difference -0.15; 95% confidence interval [CI], -0.22 to -0.08; P < 0.001). Subgroup analysis based on the study period showed that the DASH diet could significantly reduce fasting insulin levels when prescribed for more than 16 wk (mean difference -0.16; 95% CI, -0.23 to -0.08; P < 0.001). Meta-analysis could not show a beneficial effect of the DASH diet on FBG (mean difference -0.26; 95% CI, -0.56 to 0.05; P = 0.1), and HOMA-IR (mean difference -0.26; 95% CI, -0.56 to 0.05; P = 0.1).

CONCLUSIONS

The DASH dietary pattern may lead to an improvement in insulin sensitivity independent of weight loss. The DASH diet may play an important role in glycemic control in long- term interventions. Additional prospective studies regarding the association between DASH diet and risks for type 2 diabetes are necessary.

摘要

目的

2 型糖尿病是一个主要的公共卫生问题。饮食方法防治高血压(DASH)饮食模式可能有助于控制 2 型糖尿病的风险因素。本研究的目的是对随机对照试验(RCT)进行系统评价和荟萃分析,以检查 DASH 饮食对血糖控制指标的影响,如空腹血糖(FBG)、血清空腹胰岛素水平和稳态模型评估胰岛素抵抗(HOMA-IR)。

方法

我们检索了 Pubmed、EMBASE、Science Direct、ISI web of science 和 Google Scholar 中截至 2012 年 7 月的 RCTs。我们总共发现了 20 篇文章,分别检查了 DASH 饮食对 FBG(n=9)、空腹胰岛素(n=7)和 HOMA-IR(n=4)的影响,符合纳入标准。

结果

荟萃分析显示,DASH 饮食可显著降低空腹胰岛素浓度(平均差异-0.15;95%置信区间[CI],-0.22 至-0.08;P<0.001)。基于研究时间的亚组分析表明,当 DASH 饮食规定超过 16 周时,可显著降低空腹胰岛素水平(平均差异-0.16;95% CI,-0.23 至-0.08;P<0.001)。荟萃分析不能显示 DASH 饮食对 FBG(平均差异-0.26;95% CI,-0.56 至 0.05;P=0.1)和 HOMA-IR(平均差异-0.26;95% CI,-0.56 至 0.05;P=0.1)有有益的影响。

结论

DASH 饮食模式可能导致胰岛素敏感性的改善,而不依赖于体重减轻。DASH 饮食可能在长期干预中对血糖控制发挥重要作用。需要进行更多关于 DASH 饮食与 2 型糖尿病风险之间关系的前瞻性研究。

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