膳食抗氧化补充剂对2型糖尿病及其并发症管理的治疗效果；观察性/试验性荟萃分析研究的伞状综述
Therapeutic effects of dietary antioxidative supplements on the management of type 2 diabetes and its complications; umbrella review of observational/trials meta-analysis studies.
作者信息
Tabatabaei-Malazy Ozra, Peimani Maryam, Mohseni Shahrzad, Nikfar Shekoufeh, Abdollahi Mohammad, Larijani Bagher
机构信息
Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
出版信息
J Diabetes Metab Disord. 2022 Jun 20;21(2):1833-1859. doi: 10.1007/s40200-022-01069-1. eCollection 2022 Dec.
BACKGROUND
Controversial data on the effects of vitamins (V) and nutrients on the management of type 2 diabetes mellitus (T2DM) is available. Thus, it is aimed to clarify the role of vitamins and nutrients through an umbrella review regarding the available observational/ trials meta-analyses.
METHODS
All meta-analyses of observational and clinical trials conducted on the impact of vitamins and nutrients in T2DM published until 5 June 2021 in PubMed or Web of Sciences were included in this review. Also, the meta-analysis on children, pregnant women, type 1 DM, or in vivo/in vitro studies was excluded. Search results were reported according to the Preferred Reporting Items for Systematic reviews and Meta-Analysis (PRISMA) flowchart.
RESULTS
The overall of 93 papers (99 studies) consisting of 75 trials and 24 observational studies were included. Most studies were conducted on the effect of VD and alpha-lipoic acid (ALA) in both genders. Consumption of VD or its analogous; 20 IU/d to 450,000 IU/once for 3 weeks to 7 years showed to have a positive effect on the parameters of glucose hemostasis. Moreover, an inverse association was observed between VD level and T2DM risk. Daily consumption of 1200 mg VC for at least 12 weeks improved lipid profile and glucose hemostasis parameters. Furthermore, VB and medications for diabetic polyneuropathy (DPN) increased nerve conduction velocity. Vitamins K and E were showen to not have significant impact on T2DM. ALA had a beneficial effect on DPN symptoms after 2-4 weeks of intake of at least 300 mg/d. T2DM risk was reduced by doubling ALA intake. The effective daily doses of chromium, zinc and coenzyme Q10 on lipid profile and glucose hemostasis parameters were > 200 mg, < 25 mg, and < 200 mg, respectively.
CONCLUSION
This umbrella review suggests that dietary vitamins and nutrients can result in protective impacts the complications associated with T2DM. However, due to discrepancies between the results of the trials and observational studies is essential to conduct long-term high-qualified studies to prove the beneficial therapeutic effects of the vitamins and nutrients on T2DM and its complications.
背景
关于维生素（V）和营养素对2型糖尿病（T2DM）管理效果的数据存在争议。因此，旨在通过对现有观察性/试验荟萃分析进行综合评价来阐明维生素和营养素的作用。
方法
本综述纳入了截至2021年6月5日在PubMed或Web of Sciences上发表的所有关于维生素和营养素对T2DM影响的观察性和临床试验的荟萃分析。此外，排除了关于儿童、孕妇、1型糖尿病或体内/体外研究的荟萃分析。搜索结果按照系统评价和荟萃分析的首选报告项目（PRISMA）流程图进行报告。
结果
共纳入93篇论文（99项研究），其中包括75项试验和24项观察性研究。大多数研究针对维生素D（VD）和α-硫辛酸（ALA）对两性的影响。摄入VD或其类似物；每天20国际单位至单次450,000国际单位，持续3周至7年，对血糖止血参数有积极影响。此外，观察到VD水平与T2DM风险呈负相关。每天摄入1200毫克维生素C至少12周可改善血脂谱和血糖止血参数。此外，维生素B和治疗糖尿病性多发性神经病（DPN）的药物可提高神经传导速度。维生素K和E对T2DM无显著影响。摄入至少300毫克/天的ALA 2 - 4周后，对DPN症状有有益作用。将ALA摄入量加倍可降低T2DM风险。铬、锌和辅酶Q10对血脂谱和血糖止血参数的有效日剂量分别>200毫克、<25毫克和<200毫克。
结论
本综合评价表明，膳食维生素和营养素可对与T2DM相关的并发症产生保护作用。然而，由于试验和观察性研究结果存在差异，有必要进行长期高质量研究，以证明维生素和营养素对T2DM及其并发症的有益治疗效果。
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