2型糖尿病中的微量元素状况：一项荟萃分析。
Trace element status in type 2 diabetes: A meta-analysis.
作者信息
Sanjeevi Namrata, Freeland-Graves Jeanne, Beretvas S Natasha, Sachdev Prageet K
机构信息
Postdoctoral Fellow, Health Behavior Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development, 6710B Rockledge Drive Room 3165A, MSC 7004, Bethesda, MD 20817, USA,
Department of Nutritional Sciences, The University of Texas at Austin, 1 University Station A2703, Austin, TX 78712, USA,
出版信息
J Clin Diagn Res. 2018 May;12(5):OE01-OE08. doi: 10.7860/JCDR/2018/35026.11541.
INTRODUCTION
Type 2 diabetes is a chronic metabolic disorder that has been associated with alterations in the status of trace elements, including zinc, copper, iron and manganese. However, clinical studies reporting statuses of these trace elements in type 2 diabetes patients compared to controls have shown conflicting results.
OBJECTIVE
This meta-analysis aimed to summarize the existing literature on the statuses of zinc, copper, iron, and manganese in Type 2 diabetes mellitus patients.
METHODS
A literature search of Embase, PubMed, EBSCOHost, ScienceDirect, Scopus, Cochrane library and Web of Science electronic databases was conducted to find studies published from 1970 to November 2016 that compared the trace elements of interest between type 2 diabetic patients and healthy controls. Keywords used were type 2 diabetes, diabetes, hyperglycemia, insulin, glucose, HbA1c, trace elements, micronutrients, zinc, manganese, copper, ceruloplasmin, iron and ferritin. The bias corrected Hedges' g, was utilized as the effect sizes. Due to the biological interaction between trace elements, it is important to collectively evaluate the statuses of these minerals in type 2 diabetes. Thus, the robust variance estimation method was chosen to handle dependency between multiple outcomes.
RESULTS
A total of 52 studies met the inclusion criteria, amounting to 98 effect sizes. Diabetic patients (n=20183) had significantly lower zinc status when compared to controls (effect size = -1.73, p<0.01); whereas copper (effect size = 1.10, p<0.05) and ferritin levels (effect size = 1.05, p<0.01) were significantly higher. Although not significant, ceruloplasmin (effect size = 1.85, p=0.06) and iron (effect size = 1.42, p=0.06) levels were higher, and manganese (effect size = 0.27, p=0.34) was lower in patients.
CONCLUSION
Results from this meta-analysis indicate lower zinc status accompanied by increased copper and ferritin levels in patients with type 2 diabetes when compared to controls.
引言
2型糖尿病是一种慢性代谢紊乱疾病，与包括锌、铜、铁和锰在内的微量元素状态改变有关。然而，与对照组相比，关于2型糖尿病患者这些微量元素状态的临床研究结果相互矛盾。
目的
本荟萃分析旨在总结现有关于2型糖尿病患者锌、铜、铁和锰状态的文献。
方法
对Embase、PubMed、EBSCOHost、ScienceDirect、Scopus、Cochrane图书馆和Web of Science电子数据库进行文献检索，以查找1970年至2016年11月发表的比较2型糖尿病患者和健康对照之间感兴趣的微量元素的研究。使用的关键词有2型糖尿病、糖尿病、高血糖、胰岛素、葡萄糖、糖化血红蛋白、微量元素、微量营养素、锌、锰、铜、铜蓝蛋白、铁和铁蛋白。偏差校正的Hedges' g用作效应量。由于微量元素之间的生物学相互作用，共同评估2型糖尿病中这些矿物质的状态很重要。因此，选择稳健方差估计方法来处理多个结果之间的相关性。
结果
共有52项研究符合纳入标准，共计98个效应量。与对照组相比，糖尿病患者（n = 20183）的锌状态显著较低（效应量 = -1.73，p < 0.01）；而铜（效应量 = 1.10，p < 0.05）和铁蛋白水平（效应量 = 1.05，p < 0.01）显著较高。虽然不显著，但患者的铜蓝蛋白（效应量 = 1.85，p = 0.06）和铁（效应量 = 1.42，p = 0.06）水平较高，锰（效应量 = 0.27，p = 0.34）水平较低。
结论
本荟萃分析结果表明，与对照组相比，2型糖尿病患者锌状态较低，同时铜和铁蛋白水平升高。
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