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生理催乳素血清水平变化与 2 型糖尿病风险的关联:系统评价和荟萃分析。

Association between variations of physiological prolactin serum levels and the risk of type 2 diabetes: A systematic review and meta-analysis.

机构信息

Endocrine Division, University Hospital of Brasilia, University of Brasilia, Brasilia, Brazil; Postgraduate Program in Health Sciences, University of Brasilia, Brazil.

Postgraduate Program in Health Sciences, University of Brasilia, Brazil.

出版信息

Diabetes Res Clin Pract. 2020 Aug;166:108247. doi: 10.1016/j.diabres.2020.108247. Epub 2020 Jun 4.

Abstract

AIM

To determine the pooled association between variations of prolactin serum levels within the physiological range and the risk of type 2 diabetes mellitus (T2D).

METHODS

Pubmed, Scopus, Web of Science, and grey literature were searched for studies investigating the association between variations of prolactin serum levels in the normal range and the risk of T2D in adults. The risk of prevalent and incident T2D was summarized as the odds ratio or relative risk according to the quartile of prolactin serum concentration, using random-effects meta-analysis.

RESULTS

Of 2,014 articles identified, 6 met the inclusion criteria. Data were pooled from cross-sectional studies including 6,670 subjects and longitudinal studies involving 13,203 subjects. Men with prolactin levels in the fourth quartile versus those in the first quartile had decreased risk of prevalent T2D (OR 0.52; 95%CI 0.35-077). The same association was seen in women (OR 0.46; 95%CI 0.30-0.73). Conversely, prolactin levels in the fourth versus first quartile were not associated with the risk of incident T2D in men (RR 1.21; 95%CI 0.79-1.87) or women (RR 0.77; 95%CI 0.48-1.22).

CONCLUSION

Higher prolactin serum levels within the normal range were associated with reduced risk of prevalent but not incident T2D. Further studies are necessary to address whether this association is causal, but these findings raise the discussion regarding the optimal level of prolactin suppression in subjects undergoing therapy with dopaminergic agonists.

摘要

目的

确定催乳素血清水平在生理范围内的变化与 2 型糖尿病(T2D)风险之间的汇总关联。

方法

检索 Pubmed、Scopus、Web of Science 和灰色文献,以调查正常范围内催乳素血清水平变化与成年人 T2D 风险之间关联的研究。根据催乳素血清浓度的四分位数,使用随机效应荟萃分析,将 T2D 的现患和新发风险总结为优势比或相对风险。

结果

在 2014 篇文章中,有 6 篇符合纳入标准。数据来自包括 6670 名受试者的横断面研究和涉及 13203 名受试者的纵向研究。与催乳素水平处于第一四分位数的男性相比,第四四分位数的男性 T2D 的现患风险降低(OR 0.52;95%CI 0.35-0.77)。同样的关联也见于女性(OR 0.46;95%CI 0.30-0.73)。相反,催乳素水平处于第四四分位数与男性(RR 1.21;95%CI 0.79-1.87)或女性(RR 0.77;95%CI 0.48-1.22)的 T2D 新发风险无关。

结论

正常范围内较高的催乳素血清水平与现患 T2D 的风险降低相关,但与新发 T2D 风险无关。需要进一步的研究来确定这种关联是否具有因果关系,但这些发现引发了关于接受多巴胺激动剂治疗的受试者中催乳素抑制最佳水平的讨论。

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