Jinan Central Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China,
Jinan Central Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China.
Arch Endocrinol Metab. 2022 Apr 28;66(2):157-167. doi: 10.20945/2359-3997000000441. Epub 2022 Mar 14.
The prevalence of diabetes mellitus is increasing and is related to sedentary lifestyles and obesity. Many studies were published on the effect of lifestyle interventions on glucose regulation and delay the onset of diabetes in adults with impaired glucose tolerance (IGT) or prediabetes. This study aimed to investigate the role of lifestyle interventions in individuals with IGT or prediabetes using a meta-analytic approach. PubMed, Embase, and the Cochrane Central Register of Controlled Trials databases were searched from their inception up to January 2020 to select eligible randomized controlled trials (RCTs). The weighted mean difference (WMD; for fasting plasma glucose (FPG) and 2-hour plasma glucose (2hPPG)) or relative risk (RR; for the risk of diabetes) with 95% confidence interval (CI) were calculated for pooled effect estimates using the random-effects model. Thirteen RCTs involving 3376 individuals with IGT or prediabetes were selected for this meta-analysis. The results showed that lifestyle interventions were associated with lower FPG (WMD: -0.14; 95% CI: -0.24 to -0.05 mmol/L; =0.004) and 2hPPG (WMD: -0.66; 95% CI: -1.12 to -0.20 mmol/L; =0.005) in adults with IGT or prediabetes. Moreover, the risk of diabetes was significantly reduced in individuals who received lifestyle interventions (RR: 0.75; 95% CI: 0.60-0.95; =0.015). Lifestyle interventions could help improve glucose dysregulation and prevent the progression of diabetes in adults with IGT or prediabetes. Further large-scale RCTs should be conducted to assess the effects of long-term lifestyle interventions on diabetic complications in adults with IGT or prediabetes.
糖尿病的患病率正在上升，这与久坐的生活方式和肥胖有关。许多研究发表了关于生活方式干预对葡萄糖调节的影响，并延缓了糖耐量受损（IGT）或糖尿病前期成年人糖尿病的发病。本研究旨在采用荟萃分析方法研究生活方式干预在 IGT 或糖尿病前期个体中的作用。从成立到 2020 年 1 月，我们在 PubMed、Embase 和 Cochrane 对照试验中心注册数据库中搜索了合格的随机对照试验（RCT）。使用随机效应模型计算汇总效应估计的加权均数差（WMD；用于空腹血糖（FPG）和 2 小时血糖（2hPPG））或相对风险（RR；用于糖尿病风险），置信区间为 95%。这项荟萃分析纳入了 13 项涉及 3376 名 IGT 或糖尿病前期患者的 RCT。结果表明，生活方式干预与 IGT 或糖尿病前期成年人的 FPG（WMD：-0.14；95%CI：-0.24 至 -0.05 mmol/L；=0.004）和 2hPPG（WMD：-0.66；95%CI：-1.12 至 -0.20 mmol/L；=0.005）降低相关。此外，接受生活方式干预的个体糖尿病风险显著降低（RR：0.75；95%CI：0.60-0.95；=0.015）。生活方式干预可以帮助改善葡萄糖失调，预防 IGT 或糖尿病前期成年人糖尿病的进展。应进行进一步的大规模 RCT 以评估长期生活方式干预对 IGT 或糖尿病前期成年人糖尿病并发症的影响。
