School of Health Sciences, University of Greenwich, London SE9 2UG, UK.
The School of Nursing, Soochow University, Suzhou 215006, China.
Int J Environ Res Public Health. 2019 Nov 29;16(23):4795. doi: 10.3390/ijerph16234795.
There is an increasing prevalence of diabetes worldwide and substance abuse has been observed as a problem among some people with diabetes. Therefore, there is an urgent need to understand the association between unhealthy drug use including the abuse of opium and clinical outcomes including its impact on lipid profile in patients with diabetes as the presence of these conditions can increase the risk of cardiovascular morbidity and mortality.
This was a systematic review and meta-analysis which evaluated the impact of opium abuse on lipid profile in patients with diabetes.
This systematic review was conducted in line with the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines. Three databases (Embase, PubMed, and PsycINFO) plus Google Scholar were searched for relevant articles from database inception to 18 July 2019 based on the Population, Intervention, Comparator, and Outcomes (PICO) framework. The studies included were based on a set of inclusion and exclusion criteria including patients with diabetes who abused opium. Articles were evaluated for risk of bias and the meta-analysis was conducted using Revman.
Six articles that met the criteria were included in the systematic review and meta-analysis. The type of substance abused was opium in all the studies. The results of the meta-analysis showed that opium abuse significantly ( = 0.01) lowered total cholesterol compared to control with a mean difference of -0.17 (95% CI, -0.29, -0.04) in patients with diabetes. With respect to high-density lipoprotein (HDL) cholesterol, low-density lipoprotein (LDL) cholesterol, triglycerides, and body mass index, the differences were not statistically significant ( > 0.05) between those who abused opium compared with the control. Nutritional deficiencies, weight loss and lipid dysregulation due to liver dysfunction which are found in people who abuse substances may explain the findings of the current review with respect to lipid profile in patients with diabetes who abuse opium compared with the control.
The findings of this systematic review and meta-analysis have shown that opium abuse significantly decreased total cholesterol ( < 0.05) in patients with diabetes. However, the effect of opium abuse on HDL cholesterol, triglycerides, body mass index (BMI) and LDL cholesterol in these patients were not statistically significant ( > 0.05) compared with the control. This result has public health significance in terms of ensuring the promotion of adequate nutritional intake in patients with diabetes who abuse opium.
本系统评价和荟萃分析旨在评估鸦片滥用对糖尿病患者血脂谱的影响。
本系统评价根据系统评价和荟萃分析的首选报告项目（PRISMA）指南进行。根据人群、干预、比较和结局（PICO）框架，从数据库成立到 2019 年 7 月 18 日，在 3 个数据库（Embase、PubMed 和 PsycINFO）和 Google Scholar 上搜索相关文章。纳入的研究基于一套纳入和排除标准，包括滥用鸦片的糖尿病患者。对文章进行偏倚风险评估，并使用 Revman 进行荟萃分析。
纳入了 6 项符合标准的系统评价和荟萃分析。所有研究中滥用的物质类型均为鸦片。荟萃分析结果表明，与对照组相比，鸦片滥用显著（ = 0.01）降低了总胆固醇，糖尿病患者的平均差异为-0.17（95%CI：-0.29，-0.04）。至于高密度脂蛋白（HDL）胆固醇、低密度脂蛋白（LDL）胆固醇、甘油三酯和体重指数，与对照组相比，滥用鸦片的患者差异无统计学意义（ > 0.05）。营养缺乏、因肝功能障碍导致的体重减轻和脂质失调可能解释了当前研究中与糖尿病患者相比，滥用鸦片对血脂谱的影响，这些都是滥用物质的人群中常见的现象。
本系统评价和荟萃分析的结果表明，鸦片滥用显著降低了糖尿病患者的总胆固醇（ < 0.05）。然而，与对照组相比，鸦片滥用对这些患者的 HDL 胆固醇、甘油三酯、体重指数（BMI）和 LDL 胆固醇的影响无统计学意义（ > 0.05）。对于确保在滥用鸦片的糖尿病患者中促进充足的营养摄入，这一结果具有公共卫生意义。
