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2型糖尿病非酒精性脂肪性肝病的维生素D补充治疗:一项系统评价和荟萃分析方案

Vitamin D supplementation for nonalcoholic fatty liver disease in type 2 diabetes mellitus: A protocol for a systematic review and meta-analysis.

作者信息

Wang Shengju, Cai Baochao, Han Xuke, Gao Yang, Zhang Xiaoran, Wang Ruili, Zhang Yuan, Chen Qiu

机构信息

Department of Endocrinology, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu 610072.

Endocrinology Department, Jiaxing Hospital of Traditional Chinese Medicine, Jiaxing 314001.

出版信息

Medicine (Baltimore). 2020 May;99(19):e20148. doi: 10.1097/MD.0000000000020148.

Abstract

BACKGROUND

Nonalcoholic fatty liver disease (NAFLD) is strongly associated with type 2 diabetes mellitus (T2DM), and low vitamin D levels are positively associated with NAFLD and T2DM. But there is absence of convincing evidence-based medicine to confirm the efficacy of vitamin D supplementation for T2DM with NAFLD. Thus, we aimed to conduct this meta-analysis to summarize the efficacy of vitamin D supplementation for T2DM combined with NAFLD, and help to further clarify its beneficial action on diabetic patients with NAFLD.

METHODS

The study only selects clinical randomized controlled trials of vitamin D supplementation for T2DM combined with NAFLD. We will search each database from the built-in until July 2020. The English literature mainly searches Cochrane Library, Pubmed, EMBASE, and Web of Science. While the Chinese literature comes from CNKI, CBM, VIP, and Wangfang database. Meanwhile, we will retrieve clinical trial registries and grey literature. Two researchers worked independently on literature selection, data extraction, and quality assessment. The dichotomous data is represented by relative risk (RR), and the continuous is expressed by mean difference (MD) or standard mean difference (SMD), eventually the data is synthesized using a fixed effect model (FEM) or a random effect model (REM) depending on the heterogeneity. The imaging markers of liver, biomarkers of hepatic steatosis, serological indexes of hepatic fibrosis, serum NAFLD liver fat score were evaluated as the main outcomes. While several secondary outcomes were also evaluated in this study. The statistical analysis of this meta-analysis was conducted by RevMan software version 5.3.

RESULTS

This meta-analysis will further determine the beneficial efficacy of vitamin D supplementation for T2DM combined with NAFLD.

CONCLUSION

This study determines the positive efficacy of vitamin D supplementation for diabetic patients with NAFLD.

摘要

背景

非酒精性脂肪性肝病(NAFLD)与2型糖尿病(T2DM)密切相关,低维生素D水平与NAFLD和T2DM呈正相关。但目前缺乏令人信服的循证医学证据来证实补充维生素D对合并NAFLD的T2DM的疗效。因此,我们旨在进行这项荟萃分析,以总结补充维生素D对合并NAFLD的T2DM的疗效,并有助于进一步阐明其对合并NAFLD的糖尿病患者的有益作用。

方法

本研究仅选择补充维生素D治疗合并NAFLD的T2DM的临床随机对照试验。我们将检索自建库至2020年7月的各个数据库。英文文献主要检索Cochrane图书馆、Pubmed、EMBASE和Web of Science。中文文献来自中国知网、中国生物医学文献数据库、维普数据库和万方数据库。同时,我们将检索临床试验注册库和灰色文献。两名研究人员独立进行文献筛选、数据提取和质量评估。二分数据用相对危险度(RR)表示,连续性数据用均数差(MD)或标准化均数差(SMD)表示,最终根据异质性采用固定效应模型(FEM)或随机效应模型(REM)对数据进行合并。将肝脏影像学标志物、肝脂肪变性生物标志物、肝纤维化血清学指标、血清NAFLD肝脂肪评分作为主要结局指标。本研究还评估了几个次要结局指标。本荟萃分析的统计分析采用RevMan 5.3软件进行。

结果

本荟萃分析将进一步确定补充维生素D对合并NAFLD的T2DM的有益疗效。

结论

本研究确定了补充维生素D对合并NAFLD的糖尿病患者的积极疗效。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0702/7220265/4c8d9a811df0/medi-99-e20148-g002.jpg

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