瑜伽对2型糖尿病患者血糖和血脂参数的影响：一项荟萃分析。
Effect of yoga on glycemia and lipid parameters in type-2 diabetes: a meta-analysis.
作者信息
Dutta Deep, Bhattacharya Saptarshi, Sharma Meha, Khandelwal Deepak, Surana Vineet, Kalra Sanjay
机构信息
Department of Endocrinology, Center for Endocrinology, Diabetes, Arthritis & Rheumatism (CEDAR) Super-speciality Clinics, Dwarka, New Delhi, 110075 India.
Department of Endocrinology, Max Superspeciality Hospital, New Delhi, India.
出版信息
J Diabetes Metab Disord. 2021 Feb 1;20(1):349-367. doi: 10.1007/s40200-021-00751-0. eCollection 2021 Jun.
PURPOSE
Prior systematic reviews on yoga and diabetes have given conflicting results. They have been limited by inclusion of uncontrolled unblinded single group observational studies. No reviews are available which have used the Cochrane methodology and GRADE (Grades of Recommendation, Assessment, Development and Evaluation) approach. This meta-analysis evaluated the efficacy of yoga on glycaemia and lipids in T2DM using the Cochrane methodology and GRADE approach.
METHODS
Major repositories were searched to pick randomized controlled trials involving T2DM patients receiving yoga. Primary outcome was to evaluate changes in fasting plasma glucose (FPG) and glycated haemoglobin (HbA1c). Secondary outcomes were to evaluate changes in post-prandial plasma glucose (PPG), total cholesterol (TC), triglycerides, low-density lipoprotein cholesterol (LDL-C) and high-density lipoprotein cholesterol (HDL-C). Sub-group analysis involving people undergoing structured exercise regimen (SER) versus those undergoing standard diabetes care in controls was done.
RESULTS
Data from 13 studies involving 1440 patients were analysed. Compared to controls, individuals doing yoga had significantly lower FPG [mean difference (MD) -17.22 mg/dl (95% CI: -26.19 - -8.26 mg/dl); < 0.01; considerable heterogeneity (CH); low certainty of evidence (LCE)], PPG [MD -27.77 mg/dl (95% CI: -35.73 - -19.81 mg/dl); < 0.01; low heterogeneity; moderate certainty of evidence (MCE)], TC [MD -19.48 mg/dl (95% CI: -31.97 - -6.99 mg/dl); < 0.01; CH; LCE], triglycerides [MD -12.99 mg/dl (95% CI: -23.74 - -2.25 mg/dl); < 0.01; CH; LCE], LDL-C [MD -11.71 mg/dl (95% CI: -17.49 - -5.93 mg/dl); < 0.01; I = 69% CH; LCE] and significantly higher HDL-C [MD 4.58 mg/dl (95% CI: 3.98-5.18 mg/dl); < 0.01; low heterogeneity; MCE]. On sub-group analysis, where yoga was compared to SER, FPG was significantly lower in yoga group.
CONCLUSION
Yoga improves glycaemia and lipid parameters in T2DM with additional benefits seen both in people doing/not doing structured exercise.
SUPPLEMENTARY INFORMATION
The online version contains supplementary material available at 10.1007/s40200-021-00751-0.
目的
先前关于瑜伽与糖尿病的系统评价结果相互矛盾。这些评价受到纳入非对照、非盲法单组观察性研究的限制。目前尚无采用Cochrane方法和GRADE（推荐分级、评估、制定与评价）方法的综述。本荟萃分析采用Cochrane方法和GRADE方法评估瑜伽对2型糖尿病患者血糖和血脂的疗效。
方法
检索主要数据库，选取涉及接受瑜伽治疗的2型糖尿病患者的随机对照试验。主要结局是评估空腹血糖（FPG）和糖化血红蛋白（HbA1c）的变化。次要结局是评估餐后血糖（PPG）、总胆固醇（TC）、甘油三酯、低密度脂蛋白胆固醇（LDL-C）和高密度脂蛋白胆固醇（HDL-C）的变化。进行了亚组分析，比较了接受结构化运动方案（SER）的人群与对照组中接受标准糖尿病护理的人群。
结果
分析了13项研究中1440例患者的数据。与对照组相比，进行瑜伽锻炼的个体FPG显著降低[平均差值（MD）-17.22mg/dl（95%CI：-26.19--8.26mg/dl）；P<0.01；显著异质性（CH）；低证据确定性（LCE）]，PPG[MD-27.77mg/dl（95%CI：-35.73--19.81mg/dl）；P<0.01；低异质性；中等证据确定性（MCE）]，TC[MD-19.48mg/dl（95%CI：-31.97--6.99mg/dl）；P<0.01；CH；LCE]，甘油三酯[MD-12.99mg/dl（95%CI：-23.74--2.25mg/dl）；P<0.01；CH；LCE]，LDL-C[MD-11.71mg/dl（95%CI：-17.49--5.93mg/dl）；P<0.01；I=69%CH；LCE]，且HDL-C显著升高[MD 4.58mg/dl（95%CI：3.98-5.18mg/dl）；P<0.01；低异质性；MCE]。在亚组分析中，将瑜伽与SER进行比较时，瑜伽组的FPG显著更低。
结论
瑜伽可改善2型糖尿病患者的血糖和血脂参数，无论是否进行结构化运动的人群均能从中获益。
补充信息
在线版本包含可在10.1007/s40200-021-00751-0获取的补充材料。
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