Teikyo University Graduate School of Public Health, 2-11-1 Kaga, Itabashi-ku, Tokyo 173-8605, Japan.
Center for Medical Statistics, 2-9-6, Shiodome Italia-gai Siodome First 4F, Higashi Shinbashi, Minato-ku, Tokyo 105-0021, Japan.
Nutrients. 2019 Jun 19;11(6):1373. doi: 10.3390/nu11061373.
Many clinical trials have been conducted to verify the effects of interventions for prevention of type 2 diabetes (T2D) using different treatments and outcomes. The aim of this study was to compare the effectiveness of lifestyle modifications (LM) with other treatments in persons at high risk of T2D by a network meta-analysis (NMA).
Searches were performed of PUBMED up to January 2018 to identify randomized controlled trials. The odds ratio (OR) with onset of T2D at 1 year in the intervention group (LM, dietary, exercise, or medication) versus a control group (standard treatments or placebo) were the effect sizes. Frequentist and Bayesian NMAs were conducted.
Forty-seven interventions and 12 treatments (20,113 participants) were used for the analyses. The OR in the LM was approximately 0.46 (95% CI: 0.33 to 0.61) times lower compared to the standard intervention by the Bayesian approach. The effects of LM compared to other treatments by indirect comparisons were not significant.
This meta-analysis further strengthened the evidence that LM reduces the onset of T2D compared to standard and placebo interventions and appears to be at least as effective as nine other treatments in preventing T2D.
许多临床试验已经证实了不同干预措施对预防 2 型糖尿病（T2D）的效果，这些干预措施的作用各不相同。本研究旨在通过网络荟萃分析（NMA）比较生活方式干预与其他治疗方法对 T2D 高危人群的有效性。
截至 2018 年 1 月，通过 PUBMED 检索随机对照试验。将干预组（生活方式干预、饮食、运动或药物）与对照组（标准治疗或安慰剂）在 1 年内发生 T2D 的比值比（OR）作为疗效指标。进行了频率论和贝叶斯 NMA。
共纳入 47 项干预措施和 12 种治疗方法（20113 名参与者）进行分析。贝叶斯方法分析结果显示，与标准干预相比，生活方式干预的 OR 大约低 0.46 倍（95%CI：0.33 至 0.61）。间接比较结果显示，与其他治疗相比，生活方式干预的效果无显著差异。
本荟萃分析进一步强化了生活方式干预可降低 T2D 发病风险的证据，且与标准干预和安慰剂相比，生活方式干预至少与其他 9 种治疗方法同样有效。
