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肉桂在 2 型糖尿病中的应用:一项更新的系统评价和荟萃分析。

Cinnamon use in type 2 diabetes: an updated systematic review and meta-analysis.

机构信息

College of Pharmacy, Western University of Health Sciences, Pomona, California.

出版信息

Ann Fam Med. 2013 Sep-Oct;11(5):452-9. doi: 10.1370/afm.1517.

Abstract

PURPOSE

Cinnamon has been studied in randomized controlled trials (RCTs) for its glycemic-lowering effects, but studies have been small and show conflicting results. A prior meta-analysis did not show significant results, but several RCTs have been published since then. We conducted an updated systematic review and meta-analysis of RCTs evaluating cinnamon's effect on glycemia and lipid levels.

METHODS

MEDLINE, Embase, and Cochrane Central Register of Controlled Trials (CENTRAL) were searched through February 2012. Included RCTs evaluated cinnamon compared with control in patients with type 2 diabetes and reported at least one of the following: glycated hemoglobin (A1c), fasting plasma glucose, total cholesterol, low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), or triglycerides. Weighted mean differences (with 95% confidence intervals) for endpoints were calculated using random-effects models.

RESULTS

In a meta-analysis of 10 RCTs (n = 543 patients), cinnamon doses of 120 mg/d to 6 g/d for 4 to 18 weeks reduced levels of fasting plasma glucose (-24.59 mg/dL; 95% CI, -40.52 to -8.67 mg/dL), total cholesterol (-15.60 mg/dL; 95% CI, -29.76 to -1.44 mg/dL), LDL-C (-9.42 mg/dL; 95% CI, -17.21 to -1.63 mg/dL), and triglycerides (-29.59 mg/dL; 95% CI, -48.27 to -10.91 mg/dL). Cinnamon also increased levels of HDL-C (1.66 mg/dL; 95% CI, 1.09 to 2.24 mg/dL). No significant effect on hemoglobin A1c levels (-0.16%; 95%, CI -0.39% to 0.02%) was seen. High degrees of heterogeneity were present for all analyses except HDL-C (I(2) ranging from 66.5% to 94.72%).

CONCLUSIONS

The consumption of cinnamon is associated with a statistically significant decrease in levels of fasting plasma glucose, total cholesterol, LDL-C, and triglyceride levels, and an increase in HDL-C levels; however, no significant effect on hemoglobin A1c was found. The high degree of heterogeneity may limit the ability to apply these results to patient care, because the preferred dose and duration of therapy are unclear.

摘要

目的

已有研究表明肉桂具有降低血糖的作用,但这些研究规模较小且结果相互矛盾。先前的荟萃分析并未显示出显著的结果,但此后已有多项随机对照试验(RCT)发表。我们对评估肉桂对血糖和血脂水平影响的 RCT 进行了更新的系统评价和荟萃分析。

方法

通过 MEDLINE、Embase 和 Cochrane 对照试验中心注册库(CENTRAL)检索至 2012 年 2 月。纳入的 RCT 将肉桂与 2 型糖尿病患者的对照进行比较,并至少报告了以下一项结果:糖化血红蛋白(A1c)、空腹血糖、总胆固醇、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)或甘油三酯。使用随机效应模型计算终点的加权均数差值(95%置信区间)。

结果

在对 10 项 RCT(n = 543 名患者)的荟萃分析中,肉桂剂量为 120 mg/d 至 6 g/d,持续 4 至 18 周,可降低空腹血糖(-24.59 mg/dL;95%置信区间,-40.52 至-8.67 mg/dL)、总胆固醇(-15.60 mg/dL;95%置信区间,-29.76 至-1.44 mg/dL)、LDL-C(-9.42 mg/dL;95%置信区间,-17.21 至-1.63 mg/dL)和甘油三酯(-29.59 mg/dL;95%置信区间,-48.27 至-10.91 mg/dL)。肉桂还可升高 HDL-C(1.66 mg/dL;95%置信区间,1.09 至 2.24 mg/dL)。血红蛋白 A1c 水平未见显著变化(-0.16%;95%置信区间,-0.39% 至 0.02%)。除 HDL-C 外(I²为 66.5%至 94.72%),所有分析均存在高度异质性。

结论

肉桂的摄入与空腹血糖、总胆固醇、LDL-C 和甘油三酯水平的统计学显著降低以及 HDL-C 水平的统计学显著升高相关;然而,血红蛋白 A1c 水平未见显著变化。高度异质性可能限制了将这些结果应用于患者护理的能力,因为尚不清楚最佳的治疗剂量和持续时间。

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