素食饮食与糖尿病的血糖控制：一项系统评价与荟萃分析。
Vegetarian diets and glycemic control in diabetes: a systematic review and meta-analysis.
作者信息
Yokoyama Yoko, Barnard Neal D, Levin Susan M, Watanabe Mitsuhiro
机构信息
1 Graduate School of Media and Governance, Keio University, 5322 Endo, Fujisawa, Kanagawa, 252-0882, Japan ; 2 Department of Medicine, The George Washington University School of Medicine, Washington, DC, USA ; 3 Physicians Committee for Responsible Medicine, Washington, DC, USA ; 4 Department of Internal Medicine, School of Medicine, Keio University, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan ; 5 Health Science Laboratory, Graduate School of Media and Governance, Faculty of Environment and Information Studies, Keio University, 5322 Endo, Fujisawa, Kanagawa, 252-0882, Japan.
出版信息
Cardiovasc Diagn Ther. 2014 Oct;4(5):373-82. doi: 10.3978/j.issn.2223-3652.2014.10.04.
INTRODUCTION
Previous studies have suggested an association between vegetarian diets and improvements in glycemic control in diabetes, although this relationship is not well established. No meta-analysis of these studies has been performed.
METHODS
To conduct a systematic review and meta-analysis of controlled clinical trials examining the association between vegetarian diets and glycemic control in type 2 diabetes.
DATA SOURCE
The electronic databases Medline, Web of Science, Excerpta Medica Database (EMBASE), and Cochrane Central Register of Controlled Trials were searched for articles published in any language through December 9, 2013.
STUDY SELECTION
The following criteria were used for study inclusion: (I) age of participants >20 years; (II) vegetarian diet as intervention; (III) mean difference in hemoglobin A1c (HbA1c) and/or fasting blood glucose levels used as outcomes; and (IV) controlled trials, duration ≥4 weeks. Exclusion criteria were: (I) not an original investigation; (II) duplicate samples; (III) diabetes other than type 2; (IV) multiple interventions; and (V) uncontrolled studies.
DATA EXTRACTION AND SYNTHESIS
The data collected included study design, baseline population characteristics, dietary data, and outcomes. Data were pooled using a random-effects model.
MAIN OUTCOMES AND MEASURES
Differences in HbA1c and fasting blood glucose levels associated with vegetarian diets were assessed.
RESULTS
Of 477 studies identified, six met the inclusion criteria (n=255, mean age 42.5 years). Consumption of vegetarian diets was associated with a significant reduction in HbA1c [-0.39 percentage point; 95% confidence interval (CI), -0.62 to -0.15; P=0.001; I(2)=3.0; P for heterogeneity =0.389], and a non-significant reduction in fasting blood glucose concentration (-0.36 mmol/L; 95% CI, -1.04 to 0.32; P=0.301; I(2)=0; P for heterogeneity =0.710), compared with consumption of comparator diets.
CONCLUSIONS
Consumption of vegetarian diets is associated with improved glycemic control in type 2 diabetes. PROSPERO registration number is CRD42013004370.
引言
既往研究提示素食饮食与糖尿病患者血糖控制改善之间存在关联，尽管这种关系尚未完全确立。尚未对这些研究进行荟萃分析。
方法
对探讨素食饮食与2型糖尿病患者血糖控制之间关联的对照临床试验进行系统评价和荟萃分析。
数据来源
检索电子数据库Medline、科学引文索引（Web of Science）、医学文摘数据库（EMBASE）和Cochrane对照试验中心注册库，查找截至2013年12月9日以任何语言发表的文章。
研究选择
纳入研究的标准如下：（I）参与者年龄>20岁；（II）以素食饮食作为干预措施；（III）以糖化血红蛋白（HbA1c）和/或空腹血糖水平的平均差异作为结局指标；（IV）对照试验，持续时间≥4周。排除标准为：（I）非原创研究；（II）重复样本；（III）非2型糖尿病；（IV）多种干预措施；（V）非对照研究。
数据提取与综合分析
收集的数据包括研究设计、基线人群特征、饮食数据和结局指标。采用随机效应模型汇总数据。
主要结局指标
评估与素食饮食相关的HbA1c和空腹血糖水平差异。
结果
在检索到的477项研究中，6项符合纳入标准（n = 255，平均年龄42.5岁）。与对照饮食相比，食用素食饮食与HbA1c显著降低相关[-0.39个百分点；95%置信区间（CI），-0.62至-0.15；P = 0.001；I(2)=3.0；异质性检验P = 0.389]，空腹血糖浓度有非显著性降低（-0.36 mmol/L；95% CI，-1.04至0.32；P = 0.301；I(2)=0；异质性检验P = 0.710）。
结论
食用素食饮食与2型糖尿病患者血糖控制改善相关。国际前瞻性系统评价注册库（PROSPERO）注册号为CRD42013004370。
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