Li Chaolin, Shi Hao
Jinniu District Maternal and Child Health Hospital, Chengdu, 610000, China.
Department of Pediatrics, Jinniu District Maternal and Child Health Hospital, Chengdu, 610000, China.
Arch Gynecol Obstet. 2024 May;309(5):1959-1969. doi: 10.1007/s00404-023-07100-x. Epub 2023 Jun 12.
Inositol is a potential new therapeutic agent for gestational diabetes mellitus (GDM), but its effectiveness is still controversial. The aim of the report was to evaluate the effectiveness of inositol to preventing or reducing the severity of GDM.
We searched PubMed, EmBase, Web of science, Cochrane library databases, Clinicaltrials.gov, and International Clinical Trials Registry Platform for randomized controlled trials (RCTs) assessing the effectiveness of inositol supplementation to prevent and treat GDM. This meta-analysis was performed using the random-effects model.
A total of 7 RCTs (1319 pregnant women at high risk of GDM) were included in the meta-analysis. The meta-analysis found that inositol supplementation resulted in a significantly lower incidence of GDM in the inositol versus the control group (odds ratio [OR] 0.40; 95% confidence interval [CI] 0.24-0.67; P = 0.0005). The inositol group had improved fasting glucose oral glucose tolerance test (FG OGTT; mean difference [MD] = - 3.20; 95% CI - 4.45 to - 1.95; P < 0.00001), 1-h OGTT (MD = - 7.24; 95% CI - 12.23 to - 2.25; P = 0.004), and 2-h OGTT (MD = - 7.15; 95% CI - 12.86 to - 1.44; P = 0.01) results. Inositol also reduced the risk of pregnancy-induced hypertension (OR 0.37; 95% CI 0.18-0.75; P = 0.006) and preterm birth (OR 0.35; 95% CI 0.18-0.69; P = 0.003). A meta-analysis of 4 RCTs including 320 GDM patients showed that the patients' insulin resistance (P < 0.05) and neonatal hypoglycemia risk (OR 0.10, 95% CI 0.01-0.88; P = 0.04) were lower in the inositol than in the control group.
Inositol supplementation during pregnancy has the potential to prevent GDM, improve glycemic control, and reduce preterm birth rates.
肌醇是一种治疗妊娠期糖尿病(GDM)的潜在新型治疗药物,但其有效性仍存在争议。本报告旨在评估肌醇预防或降低GDM严重程度的有效性。
我们检索了PubMed、EmBase、科学网、Cochrane图书馆数据库、Clinicaltrials.gov和国际临床试验注册平台,以查找评估补充肌醇预防和治疗GDM有效性的随机对照试验(RCT)。本荟萃分析采用随机效应模型进行。
荟萃分析共纳入7项RCT(1319名GDM高危孕妇)。荟萃分析发现,与对照组相比,补充肌醇可使GDM的发病率显著降低(优势比[OR]0.40;95%置信区间[CI]0.24 - 0.67;P = 0.0005)。肌醇组的空腹血糖口服葡萄糖耐量试验(FG OGTT;平均差[MD]= - 3.20;95% CI - 4.45至 - 1.95;P < 0.00001)以及1小时OGTT(MD = - 7.24;95% CI - 12.23至 - 2.25;P = 0.004)和2小时OGTT(MD = - 7.15;95% CI - 12.86至 - 1.44;P = 0.01)结果均有所改善。肌醇还降低了妊娠高血压(OR 0.37;95% CI 0.18 - 0.75;P = 0.006)和早产(OR 0.35;95% CI 0.18 - 0.69;P = 0.003)的风险。对4项包括320名GDM患者的RCT进行的荟萃分析表明,肌醇组患者的胰岛素抵抗(P < 0.05)和新生儿低血糖风险(OR 0.10,95% CI 0.01 - 0.88;P = 0.04)低于对照组。
孕期补充肌醇有可能预防GDM、改善血糖控制并降低早产率。