阿卡波糖摄入对成人血糖指标影响的系统评价、荟萃分析、剂量反应及荟萃回归分析

A systematic review, meta-analysis, dose-response, and meta-regression of the effects of acarbose intake on glycemic markers in adults.

作者信息

Dehkordi Sina Raissi, Pahlavani Naseh, Nikbaf-Shandiz Mahlagha, Bagheri Reza, Rasaei Niloufar, Darzi Melika, Rastgoo Samira, Bahari Hossein, Shiraseb Farideh, Asbaghi Omid

机构信息

Student Research Committee, Alborz University of Medical Sciences, Karaj, Iran.

Health Sciences Research Center, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran.

出版信息

J Diabetes Metab Disord. 2023 Nov 24;23(1):135-172. doi: 10.1007/s40200-023-01336-9. eCollection 2024 Jun.

Abstract

PURPOSE

Prior research has yielded mixed results regarding the impact of acarbose intake on glycemic markers. To provide a more comprehensive analysis, a systematic review and meta-analysis was performed to compile data from various randomized controlled trials (RCTs) examining the effects of acarbose intake on fasting blood sugar (FBS), insulin, hemoglobin A1C (HbA1c), and homeostasis model assessment of insulin resistance (HOMA-IR) in adults.

METHODS

To identify relevant literature up to April 2023, a comprehensive search was conducted on various scholarly databases, including PubMed, Web of Science, and Scopus databases. The effect size of the studies was evaluated using a random-effects model to calculate the weighted mean differences (WMD) and 95% confidence intervals (CI). Heterogeneity between studies was assessed using Cochran's Q test and I.

RESULTS

This systematic review and meta-analysis included a total of 101 RCTs with a total of 107 effect sizes. The effect sizes for FBS in milligrams per deciliter (mg/dl), insulin in picomoles per liter (pmol/l), hemoglobin A1C (HbA1c) in percentage (%), and homeostasis model assessment of insulin resistance (HOMA-IR) were 92, 46, 80, and 22, respectively. The pooled analysis indicated that acarbose intake resulted in significant decreases in FBS ( = 0.018), insulin ( < 0.001), HbA1c ( < 0.001), and HOMA-IR ( < 0.001).

CONCLUSION

The findings of this systematic review and meta-analysis suggest that acarbose intake can potentially lead to significant improvements in glycemic parameters by decreasing the levels of FBS, HbA1c, and insulin. However, larger and more rigorously designed studies are still needed to further evaluate and strengthen this association.

摘要

目的

先前的研究对于阿卡波糖摄入对血糖指标的影响得出了混合的结果。为了提供更全面的分析,进行了一项系统评价和荟萃分析,以汇总来自各种随机对照试验(RCT)的数据,这些试验研究了阿卡波糖摄入对成年人空腹血糖(FBS)、胰岛素、糖化血红蛋白(HbA1c)和胰岛素抵抗稳态模型评估(HOMA-IR)的影响。

方法

为了识别截至2023年4月的相关文献,对包括PubMed、科学网和Scopus数据库在内的各种学术数据库进行了全面搜索。使用随机效应模型评估研究的效应大小,以计算加权平均差(WMD)和95%置信区间(CI)。使用 Cochr an's Q检验和I评估研究之间的异质性。

结果

这项系统评价和荟萃分析共纳入101项RCT,共有107个效应大小。以毫克每分升(mg/dl)为单位的FBS、以皮摩尔每升(pmol/l)为单位的胰岛素、以百分比(%)为单位的糖化血红蛋白(HbA1c)和胰岛素抵抗稳态模型评估(HOMA-IR)的效应大小分别为92、46、80和22。汇总分析表明,摄入阿卡波糖导致FBS(P = 0.018)、胰岛素(P < 0.001)、HbA1c(P < 0.001)和HOMA-IR(P < 0.001)显著降低。

结论

这项系统评价和荟萃分析的结果表明,摄入阿卡波糖可能通过降低FBS、HbA1c和胰岛素水平,显著改善血糖参数。然而,仍需要更大规模、设计更严谨的研究来进一步评估和加强这种关联。

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