Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
Diabetes Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
Eur J Clin Invest. 2015 Nov;45(11):1161-74. doi: 10.1111/eci.12534. Epub 2015 Sep 21.
Data regarding the effect of vitamin C (VC) and vitamin E (VE) supplementation on insulin resistance in type 2 diabetes mellitus (T2DM) are controversial. We aimed to systematically review the current data on this topic.
All randomized controlled trials (RCTs) conducted to assess the effect of VC and/or VE on insulin resistance in diabetes published in Google Scholar and PubMed web databases until January 2014 were included. Exclusion criteria were studies conducted in animal, type 1 DM, children or pregnant women. Main outcome measure was insulin resistance by homoeostasis model assessment (HOMA) index. According to degree of heterogeneity, fixed- or random-effect model was employed by stata software (11.0).
We selected 14 RCTs involving 735 patients with T2DM. VE or mixture-mode supplementation did not have any significant effect on HOMA with a standardized mean difference (SMD): 0·017, 95% CI: -0·376 to 0·411 (P = 0·932); and SMD: -0·035, 95% CI: -0·634 to 0·025 (P = 0·070), respectively, by random-effect model. VC supplement alone did not improve insulin resistance with a SMD: -0·150, 95% CI: -0·494 to 0·194 (P = 0·391), by fixed-effect model. Meta-regression test demonstrated that HOMA index may have not been influenced by the year of publication, dosage or duration of treatment.
The sole intake of VC, VE or their combination with other antioxidants could not improve insulin resistance in diabetes.
关于维生素 C(VC)和维生素 E(VE)补充剂对 2 型糖尿病(T2DM)患者胰岛素抵抗影响的数据存在争议。我们旨在系统地回顾这一主题的现有数据。
我们纳入了所有在 Google Scholar 和 PubMed 网络数据库中发表的,旨在评估 VC 和/或 VE 对糖尿病患者胰岛素抵抗影响的随机对照试验(RCT)。排除标准为在动物、1 型糖尿病、儿童或孕妇中进行的研究。主要观察指标为通过稳态模型评估(HOMA)指数评估的胰岛素抵抗。根据异质性程度,采用 stata 软件(11.0)采用固定或随机效应模型。
我们选择了 14 项涉及 735 例 T2DM 患者的 RCT。VE 或混合模式补充剂对 HOMA 无显著影响,标准化均数差(SMD):0·017,95%CI:-0·376 至 0·411(P=0·932);随机效应模型下 SMD:-0·035,95%CI:-0·634 至 0·025(P=0·070)。单独补充 VC 不能改善胰岛素抵抗,SMD:-0·150,95%CI:-0·494 至 0·194(P=0·391),固定效应模型。元回归检验表明,HOMA 指数可能不受发表年份、剂量或治疗时间的影响。
单独摄入 VC、VE 或它们与其他抗氧化剂的联合补充并不能改善糖尿病患者的胰岛素抵抗。