2型糖尿病患者中，富含单不饱和脂肪酸的饮食与富含碳水化合物或多不饱和脂肪酸的饮食相比的代谢效应：一项随机对照试验的系统评价和荟萃分析
Metabolic Effects of Monounsaturated Fatty Acid-Enriched Diets Compared With Carbohydrate or Polyunsaturated Fatty Acid-Enriched Diets in Patients With Type 2 Diabetes: A Systematic Review and Meta-analysis of Randomized Controlled Trials.
作者信息
Qian Frank, Korat Andres Ardisson, Malik Vasanti, Hu Frank B
机构信息
Pritzker School of Medicine, The University of Chicago, Chicago, IL.
Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA.
出版信息
Diabetes Care. 2016 Aug;39(8):1448-57. doi: 10.2337/dc16-0513.
OBJECTIVE
Dietary interventions in patients with type 2 diabetes (T2D) are important for preventing long-term complications. Although a healthy diet is crucial, there is still uncertainty about the optimal macronutrient composition. We performed a meta-analysis comparing diets high in cis-monounsaturated fatty acids (MUFA) to diets high in carbohydrates (CHO) or in polyunsaturated fatty acids (PUFA) on metabolic risk factors in patients with T2D.
RESEARCH DESIGN AND METHODS
We systematically reviewed PubMed, MEDLINE, and Cochrane databases and prior systematic reviews and meta-analyses to identify interventions assessing HbA1c, fasting plasma glucose and insulin, LDL and HDL cholesterol, triglycerides, body weight, or systolic/diastolic blood pressure. Meta-analyses were conducted using both fixed- and random-effects models to calculate the weighted mean difference (WMD) and 95% CI.
RESULTS
We identified 24 studies totaling 1,460 participants comparing high-MUFA to high-CHO diets and 4 studies totaling 44 participants comparing high-MUFA to high-PUFA diets. When comparing high-MUFA to high-CHO diets, there were significant reductions in fasting plasma glucose (WMD -0.57 mmol/L [95% CI -0.76, -0.39]), triglycerides (-0.31 mmol/L [-0.44, -0.18]), body weight (-1.56 kg [-2.89, -0.23]), and systolic blood pressure (-2.31 mmHg [-4.13, -0.49]) along with significant increases in HDL cholesterol (0.06 mmol/L [0.02, 0.10]). When high-MUFA diets were compared with high-PUFA diets, there was a significant reduction in fasting plasma glucose (-0.87 mmol/L [-1.67, -0.07]). All of the outcomes had low to medium levels of heterogeneity, ranging from 0.0 to 69.5% for diastolic blood pressure (Phet = 0.011).
CONCLUSIONS
Our meta-analysis provides evidence that consuming diets high in MUFA can improve metabolic risk factors among patients with T2D.
目的
对2型糖尿病（T2D）患者进行饮食干预对于预防长期并发症至关重要。尽管健康饮食至关重要，但对于最佳的宏量营养素组成仍存在不确定性。我们进行了一项荟萃分析，比较了富含顺式单不饱和脂肪酸（MUFA）的饮食与富含碳水化合物（CHO）或多不饱和脂肪酸（PUFA）的饮食对T2D患者代谢危险因素的影响。
研究设计与方法
我们系统地检索了PubMed、MEDLINE和Cochrane数据库以及先前的系统评价和荟萃分析，以确定评估糖化血红蛋白（HbA1c）、空腹血糖和胰岛素、低密度脂蛋白（LDL）和高密度脂蛋白（HDL）胆固醇、甘油三酯、体重或收缩压/舒张压的干预措施。使用固定效应模型和随机效应模型进行荟萃分析，以计算加权平均差（WMD）和95%置信区间（CI）。
结果
我们纳入了24项研究，共1460名参与者，比较了高MUFA饮食与高CHO饮食；以及4项研究，共44名参与者，比较了高MUFA饮食与高PUFA饮食。当比较高MUFA饮食与高CHO饮食时，空腹血糖（WMD -0.57 mmol/L [95%CI -0.76, -0.39]）、甘油三酯（-0.31 mmol/L [-0.44, -0.18]）、体重（-1.56 kg [-2.89, -0.23]）和收缩压（-2.31 mmHg [-4.13, -0.49]）均有显著降低，同时HDL胆固醇显著升高（0.06 mmol/L [0.02, 0.10]）。当高MUFA饮食与高PUFA饮食进行比较时，空腹血糖显著降低（-0.87 mmol/L [-1.67, -0.07]）。所有结局的异质性水平均为低到中度，舒张压的异质性范围为0.0%至69.5%（Phet = 0.011）。
结论
我们的荟萃分析提供了证据，表明食用富含MUFA的饮食可以改善T2D患者的代谢危险因素。
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