生酮饮食对 T2DM 患者血糖控制、胰岛素抵抗和脂代谢的影响：系统评价和荟萃分析。
Effect of the ketogenic diet on glycemic control, insulin resistance, and lipid metabolism in patients with T2DM: a systematic review and meta-analysis.
机构信息
Department of Clinical Nutrition, First Hospital of Jilin University, 1 Xinmin Street, 130021, Changchun, Jilin, China.
Department of Endocrinology and Metabolism, First Hospital of Jilin University, 1 Xinmin Street, 130021, Changchun, Jilin, China.
出版信息
Nutr Diabetes. 2020 Nov 30;10(1):38. doi: 10.1038/s41387-020-00142-z.
BACKGROUND
At present, the beneficial effect of the ketogenic diet (KD) on weight loss in obese patients is generally recognized. However, a systematic research on the role of KD in the improvement of glycemic and lipid metabolism of patients with diabetes is still found scarce.
METHODS
This meta-study employed the meta-analysis model of random effects or of fixed effects to analyze the average difference before and after KD and the corresponding 95% CI, thereby evaluating the effect of KD on T2DM.
RESULTS
After KD intervention, in terms of glycemic control, the level of fasting blood glucose decreased by 1.29 mmol/L (95% CI: -1.78 to -0.79) on average, and glycated hemoglobin A1c by 1.07 (95% CI: -1.37 to -0.78). As for lipid metabolism, triglyceride was decreased by 0.72 (95% CI: -1.01 to -0.43) on average, total cholesterol by 0.33 (95% CI: -0.66 to -0.01), and low-density lipoprotein by 0.05 (95% CI: -0.25 to -0.15); yet, high-density lipoprotein increased by 0.14 (95% CI: 0.03-0.25). In addition, patients' weight decreased by 8.66 (95% CI: -11.40 to -5.92), waist circumference by 9.17 (95% CI: -10.67 to -7.66), and BMI by 3.13 (95% CI: -3.31 to -2.95).
CONCLUSION
KD not only has a therapeutic effect on glycemic and lipid control among patients with T2DM but also significantly contributes to their weight loss.
背景
目前，生酮饮食（KD）在肥胖患者减轻体重方面的有益效果已得到普遍认可。然而，关于 KD 在改善糖尿病患者血糖和血脂代谢方面的作用，系统的研究仍然较少。
方法
本荟萃研究采用随机效应或固定效应的荟萃分析模型，分析 KD 前后的平均差异及其相应的 95%置信区间，从而评估 KD 对 T2DM 的影响。
结果
KD 干预后，在血糖控制方面，空腹血糖平均降低 1.29mmol/L（95%CI：-1.78 至-0.79），糖化血红蛋白 A1c 降低 1.07（95%CI：-1.37 至-0.78）。在血脂代谢方面，三酰甘油平均降低 0.72mmol/L（95%CI：-1.01 至-0.43），总胆固醇降低 0.33mmol/L（95%CI：-0.66 至-0.01），低密度脂蛋白降低 0.05mmol/L（95%CI：-0.25 至-0.15）；而高密度脂蛋白升高 0.14mmol/L（95%CI：0.03-0.25）。此外，患者体重降低 8.66kg（95%CI：-11.40 至-5.92），腰围降低 9.17cm（95%CI：-10.67 至-7.66），BMI 降低 3.13kg/m²（95%CI：-3.31 至-2.95）。
结论
KD 不仅对 T2DM 患者的血糖和血脂控制具有治疗作用，而且显著有助于其体重减轻。
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