From the 1School of Nursing, Peking Union Medical College, Chinese Academy of Medical Science, Dongcheng District, Beijing, PR China; 2School of Nursing, Johns Hopkins University, Baltimore, MD; and 3School of Continuing Education, Peking Union Medical College, Chinese Academy of Medical Science, Dongcheng District, Beijing, PR China.
Menopause. 2014 Jan;21(1):89-99. doi: 10.1097/GME.0b013e318291f5c2.
This study aims to conduct a meta-analysis to evaluate the effects of a low-fat diet, in comparison with participants' usual diet, on serum lipids in premenopausal and postmenopausal women.
Ten electronic databases were searched for relevant articles reporting randomized controlled trials through August 31, 2012, including PubMed/Medline, EMBASE, Cochrane Library, CINAHL, Web of Science, SCOPUS, ProQuest Dissertations and Theses, SinoMed, CNKI (Chinese database), and WanFang (Chinese database). This systematic review and meta-analysis, which evaluated the effects of a low-fat diet, in comparison with the participants' usual diet, was conducted according to the guidelines of the Cochrane Handbook for Systematic Reviews of Interventions. All analyses were performed using RevMan version 5 (Cochrane Collaboration).
From 512 potentially relevant publication citations reviewed, 8 randomized clinical trials were included in the meta-analysis, representing 22 groups (11 intervention groups and 11 control groups). A total of 1,536 women (900 in the intervention group and 636 in the control group) met the inclusion criteria. Total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C) values changed more favorably in participants randomized to low-fat diets than in participants randomized to their usual diets. Low-fat diet was found to induce significant reductions in TC (random-effects model: mean difference [MD], -0.49 mmol/L; 95% CI, -0.69 to -0.29; I = 42%; Peffect < 0.00001), HDL-C (MD, -0.12 mmol/L; 95% CI, -0.20 to -0.05; I = 49%; Peffect = 0.00006), and LDL-C (MD, -0.24 mmol/L; 95% CI, -0.38 to -0.09; I = 42%; Peffect = 0.001) for two groups. For subgroup analysis, low-fat diet was efficacious in reducing TC, HDL-C, and LDL-C in premenopausal women but did not significantly reduce the same outcomes in postmenopausal women. However, there were also no statistically significant differences in triglycerides (TG) and TC-to-HDL-C ratio between a low-fat diet and the participants' usual diet (TG: MD, 0.04 mmol/L; 95% CI, -0.02 to 0.11; I = 0%; Peffect = 0.16; TC-to-HDL-C ratio: MD, 0.08 mmol/L; 95%, CI -0.21 to 0.36; I = 0%; Peffect = 0.59) in two groups.
Overall results suggest that a low-fat diet is efficacious in reducing the concentrations of TC, HDL-C, and LDL-C but not in reducing TG and TC-to-HDL-C ratio in women. A low-fat diet is efficacious in reducing TC, HDL-C, and LDL-C in premenopausal women. Additional studies are needed to further address its effects on postmenopausal women.
本研究旨在进行荟萃分析，以评估低脂饮食与参与者的常规饮食相比，对绝经前和绝经后妇女的血清脂质的影响。
通过 2012 年 8 月 31 日检索了包括 PubMed/Medline、EMBASE、Cochrane 图书馆、CINAHL、Web of Science、SCOPUS、ProQuest Dissertations and Theses、SinoMed、CNKI（中国数据库）和 WanFang（中国数据库）在内的 10 个电子数据库，以报告随机对照试验的相关文章。根据 Cochrane 干预手册的指南，对评估低脂饮食的影响的系统评价和荟萃分析进行了评估。所有分析均使用 RevMan 版本 5（Cochrane 协作）进行。
从 512 篇可能相关的文献中，有 8 项随机临床试验被纳入荟萃分析，代表了 22 个组（11 个干预组和 11 个对照组）。共有 1536 名女性（干预组 900 名，对照组 636 名）符合纳入标准。与常规饮食相比，总胆固醇（TC）、高密度脂蛋白胆固醇（HDL-C）和低密度脂蛋白胆固醇（LDL-C）在接受低脂饮食的参与者中变化更有利。研究发现，低脂饮食可显著降低 TC（随机效应模型：平均差异 [MD]，-0.49mmol/L；95%CI，-0.69 至-0.29；I = 42%；Peffect < 0.00001）、HDL-C（MD，-0.12mmol/L；95%CI，-0.20 至-0.05；I = 49%；Peffect = 0.00006）和 LDL-C（MD，-0.24mmol/L；95%CI，-0.38 至-0.09；I = 42%；Peffect = 0.001）。对于亚组分析，低脂饮食在降低绝经前妇女的 TC、HDL-C 和 LDL-C 方面是有效的，但在绝经后妇女中并没有显著降低这些结果。然而，在低脂饮食与参与者的常规饮食之间，甘油三酯（TG）和 TC 与高密度脂蛋白胆固醇（HDL-C）的比值也没有统计学上的显著差异（TG：MD，0.04mmol/L；95%CI，-0.02 至 0.11；I = 0%；Peffect = 0.16；TC 与 HDL-C 的比值：MD，0.08mmol/L；95%CI，-0.21 至 0.36；I = 0%；Peffect = 0.59）。
总体结果表明，低脂饮食可有效降低 TC、HDL-C 和 LDL-C 的浓度，但不能降低 TG 和 TC 与 HDL-C 的比值。低脂饮食可有效降低绝经前妇女的 TC、HDL-C 和 LDL-C。需要进一步的研究来进一步探讨其对绝经后妇女的影响。
